Bast County Family Dental Ctr. | |
13465 Camino Canada Ste 110-a El Cajon CA 92021-8813 | |
(619) 390-3669 | |
(619) 390-3328 |
Full Name | Bast County Family Dental Ctr. |
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Speciality | Dentist |
Location | 13465 Camino Canada, El Cajon, California |
Authorized Official Name and Position | George C. Jared (PRESIDENT/OWNER) |
Authorized Official Contact | 6193903669 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Bast County Family Dental Ctr. 13465 Camino Canada Ste 110-a El Cajon CA 92021-8813 Ph: (619) 390-3669 | Bast County Family Dental Ctr. 13465 Camino Canada Ste 110-a El Cajon CA 92021-8813 Ph: (619) 390-3669 |
NPI Number | 1568573954 |
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Provider Enumeration Date | 08/31/2006 |
Last Update Date | 07/21/2022 |
Medicare PECOS PAC ID | 5294163044 |
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Medicare Enrollment ID | O20200310001992 |
Identifier | Type | State | Issuer |
---|---|---|---|
1568573954 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Provider Name | George C Jared |
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Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1568896264 PECOS PAC ID: 5092014936 Enrollment ID: I20200310002062 |
Provider Name | Tamir Shams |
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Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1942477930 PECOS PAC ID: 1850772013 Enrollment ID: I20220719002087 |
Provider Name | Ghassan Adnan Jabbar Jayyar |
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Provider Type | Practitioner - Maxillofacial Surgery |
Provider Identifiers | NPI Number: 1003528738 PECOS PAC ID: 3779945878 Enrollment ID: I20230821002589 |
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