Provider Demographics
NPI:1235324880
Name:ISMAIL, KASHIF (DMD)
Entity type:Individual
Prefix:DR
First Name:KASHIF
Middle Name:
Last Name:ISMAIL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13297 JAMBOREE RD
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92782-9159
Mailing Address - Country:US
Mailing Address - Phone:714-730-6600
Mailing Address - Fax:951-776-1571
Practice Address - Street 1:13297 JAMBOREE RD
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92782-9159
Practice Address - Country:US
Practice Address - Phone:714-730-6600
Practice Address - Fax:951-776-1571
Is Sole Proprietor?:No
Enumeration Date:2007-09-06
Last Update Date:2024-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5568122300000X
CA563331223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist