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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
Street Address |
1717 3RD ST |
City | RIVERSIDE |
State | CA |
Zip Code | 92507-3435 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356873053 | Kamran Sahabi Dental Corporation | Dentist | 1717 3rd St, Riverside, CA 92507-3435 | 2017-03-31 |
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 Code | 261QD0000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Dental |
Definition to come... |
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 |
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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.