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

Dr. Harley Albert Deisem Jr., DDS

Individual provider General Practice Dentistry · NPI 1093820557

Dr. Harley Albert Deisem Jr., DDS is a General Practice Dentistry in Chino, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2006
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

12875 Mountain Ave
Chino, CA 91710-4556
Phone: (909) 591-0316
Fax: (909) 628-4823
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 029698 (CA)

Record details

NPI number1093820557
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedAugust 21, 2006
Last updated in NPPESJuly 8, 2007

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