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 provides 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.

See every abbreviation used in this directory →

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