Provider Demographics
NPI:1871355081
Name:TSIBEL DENTAL PRACTICE INC.
Entity type:Organization
Organization Name:TSIBEL DENTAL PRACTICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARKADY
Authorized Official - Middle Name:S
Authorized Official - Last Name:TSIBEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-689-0701
Mailing Address - Street 1:10181 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-3444
Mailing Address - Country:US
Mailing Address - Phone:951-689-0701
Mailing Address - Fax:950-319-4195
Practice Address - Street 1:10181 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3444
Practice Address - Country:US
Practice Address - Phone:951-689-0701
Practice Address - Fax:950-319-4195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty