Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

LA VERNE MODERN DENTISTRY, PROF. CORP.
NPI 1215857404
Dentist - General Practice in La Verne, CA

Q: What is La Verne Modern Dentistry, Prof. Corp.'s specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Active since July 17, 2026

1500 FOOTHILL BLVD, LA VERNE, CA 91750(909) 906-3765(909) 962-8201 Get Directions Write a Review

NPPES record added: July 17, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About La Verne Modern Dentistry, Prof. Corp. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LA VERNE MODERN DENTISTRY, PROF. CORP. (NPI 1215857404) is a healthcare organization registered as a general practice in La Verne, California and active in the NPI registry since July 2026. The organization lists Abanub Wasfy Farag, Owner, as its authorized official.

NPPES Registry Identity

NPI1215857404

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NameLA VERNE MODERN DENTISTRY, PROF. CORP.

Location Address1500 FOOTHILL BLVDLa Verne, CA 91750-3434

Mailing AddressPo Box 660041Dallas, TX 75266-0041 · (714) 845-8890 · Fax (303) 952-0892

Phone(909) 906-3765

Fax(909) 962-8201

Organization SubpartNo

Authorized OfficialAbanub Wasfy FaragOwner · (909) 906-3765

Enumeration DateJuly 17, 2026

NPPES CertifiedJuly 17, 2026

✔ NPI 1215857404 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

1500 FOOTHILL BLVD, La Verne, CA 91750

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is La Verne Modern Dentistry, Prof. Corp.'s NPI number?

The NPI number for La Verne Modern Dentistry, Prof. Corp. is 1215857404. It was assigned to this organization in the NPPES registry on July 17, 2026.

Where is La Verne Modern Dentistry, Prof. Corp. located?

La Verne Modern Dentistry, Prof. Corp. is located at 1500 Foothill Blvd, La Verne, CA 91750. The listed phone number is (909) 906-3765.

What is La Verne Modern Dentistry, Prof. Corp.'s specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for La Verne Modern Dentistry, Prof. Corp. was last updated on July 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 33 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.