BASSAM W. FARGO, DDS, INC.


Address: 1717 3rd St, Riverside, CA 92507-3435
Phone: 9513297904

BASSAM W. FARGO, DDS, INC. (NPI# 1154961522) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1154961522
Entity Type Organization
Organization Name BASSAM W. FARGO, DDS, INC.
Practice Address 1717 3rd St
Riverside
CA 92507-3435
Mailing Address 11559 Springwood Ct
Riverside
CA 92505-5116
Practice Telephone 9513297904
Mailing Telephone 9513297904
Enumeration Date 2020-01-13
Last Update Date 2020-03-11
Authorized Official Name DR. BASSAM WISAM FARGO (OWNER)
Authorized Official Telephone 9513297904
Authorized Official Credential DDS
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QD0000X Clinic/Center
Specialization: Dental
Ambulatory Health Care Facilities

Office Location

Street Address 1717 3RD ST
City RIVERSIDE
State CA
Zip Code 92507-3435

Providers in the same location

NPI Name Taxonomy Address Enumeration
1356873053 Kamran Sahabi Dental Corporation Dentist 1717 3rd St, Riverside, CA 92507-3435 2017-03-31

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1205448917 Rachel Nielson Counselor 1450 Spruce St, Suite A, Riverside, CA 92507 2020-08-24
1437769742 Pakravan, Manavi & Cohen Dental Corporation Dentist 2862 Unit B Canyon Springs Parkway, Riverside, CA 92507 2020-08-03
1518577972 Michael Vincent Laureola Dds Inc Dentist 2862 Unit A Canyon Springs Parkway, Riverside, CA 92507 2020-07-31
1164067567 Audrey Gruen Social Worker Canyon Crest Mental Health, 5225 Canyon Crest Drive #100, Riverside, CA 92507 2019-11-10
1518432962 Antonio Mixon Specialist 1405 Spruce Street, Suite A, Riverside, CA 92507 2018-10-11
1811479793 New Day Counseling Services Counselor 20363 Harvard Way, Riverside, CA 92507 2018-09-06
1780176875 Miriam Martinez Case Manager/Care Coordinator 2085 Rustin Ave., Riverside, CA 92507 2018-06-04
1518478874 Lisa Manuel Counselor 2058 Rustin Ave, Riverside, CA 92507 2017-10-13
1497272942 Yajaira Placensia Behavioral Analyst 1486 Everton Place, Riverside, CA 92507 2017-08-25
1841717691 Stephanie Teuchert Behavioral Analyst 1080 Spruce Street Apartment 7c, Riverside, CA 92507 2017-08-23
Find all providers in zip 92507

Taxonomy Information

Taxonomy Code 261QD0000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Dental

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1215535182 Park and Park Dental Group Partnership Clinic/Center 473 E Alessandro Blvd Ste A, Riverside, CA 92508-6021 2020-10-13
1497315550 Dinesh Makadia Dental Inc Clinic/Center 6270 Van Buren Blvd, Riverside, CA 92503-2024 2019-06-19
1841786092 Morgan Dental Corporation Clinic/Center 3845 Pierce St Ste A, Riverside, CA 92503-4983 2018-07-10
1720577570 Indian Hills Dental, Avila Dental Corporation Clinic/Center 8300 Limonite Ave Ste C, Riverside, CA 92509-5174 2018-05-08
1659738722 Mathew Luu Dds Inc Clinic/Center 9448 Magnolia Ave Ste A, Riverside, CA 92503-3704 2016-01-20
1265873749 Jin H Park Dds Inc Clinic/Center 9295 Magnolia Ave Ste 103, Riverside, CA 92503-3800 2013-07-11
1124324561 Sergio P. Saucedo Dds Inc. Clinic/Center 6165 Valley Springs Pkwy, Suite E, Riverside, CA 92507-0963 2011-02-02
1356582076 Julia Romitan Dds,inc Clinic/Center 6860 Brockton Ave. Suite 12, Riverside, CA 92506 2009-03-09
1235259862 Nihon Shika Group Clinic/Center 1212 E Putnam Ave, Riverside, CT 06878-1431 2007-03-29
1255434676 Wayne R Low Dds Inc Clinic/Center 6862 Palm Ave, Riverside, CA 92506 2006-09-07
Find all providers in RIVERSIDE

Competitor

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City RIVERSIDE
Zip Code 92507

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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