Washington Dental Group | |
1834 Pacific Coast Hwy Lomita CA 90717-2722 | |
(310) 326-5183 | |
(310) 326-2849 |
Full Name | Washington Dental Group |
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Speciality | Dentist |
Location | 1834 Pacific Coast Hwy, Lomita, California |
Authorized Official Name and Position | David Ganji (PART OWNER) |
Authorized Official Contact | 3103265183 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Washington Dental Group 1834 Pacific Coast Hwy Lomita CA 90717-2722 Ph: (310) 326-5183 | Washington Dental Group 1834 Pacific Coast Hwy Lomita CA 90717-2722 Ph: (310) 326-5183 |
NPI Number | 1871880724 |
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Provider Enumeration Date | 06/29/2011 |
Last Update Date | 11/28/2012 |
Medicare PECOS PAC ID | 4880927953 |
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Medicare Enrollment ID | O20190604001795 |
Identifier | Type | State | Issuer |
---|---|---|---|
1871880724 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 58334 (California) | Primary |
Provider Name | David Sasha Ganji |
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Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1033346077 PECOS PAC ID: 8325371495 Enrollment ID: I20190702001972 |
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