Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

La Verne Modern Dentistry, Prof Corp

Organization General Practice Dentistry · NPI 1215857404

La Verne Modern Dentistry, Prof Corp is a General Practice Dentistry in LA Verne, California. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1500 Foothill Blvd
LA Verne, CA 91750-3434
Phone: (909) 906-3765
Fax: (909) 962-8201
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X

Record details

NPI number1215857404
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Abanub Farag — Owner · (909) 906-3765
Other names La Verne Modern Dentistry
NPI enumeratedJuly 17, 2026
Last updated in NPPESJuly 17, 2026
Certification dateJuly 17, 2026
Mailing addressPo Box 660041, Dallas, TX 75266-0041

Other providers in LA Verne