Harley Albert Deisem Jr., DDS

General Practice Dentistry · Chino, CA

Individual Active NPI

NPI number 1093820557

Practice location

12875 Mountain Ave
Chino, CA 91710-4556
Phone
(909) 591-0316
Fax
(909) 628-4823

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NPI record

NPI
1093820557
Entity type
Individual (Type 1)
Enumeration date
August 21, 2006
Last updated
July 8, 2007
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 029698 CA

About Dr. Deisem

Harley Albert Deisem Jr., DDS is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 12875 Mountain Ave, Chino, CA 91710-4556. The NPI number 1093820557 was assigned on August 21, 2006 and the record was last updated on July 8, 2007.

Dr. Deisem lists a license in the registry: #029698 (CA) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Harley Albert Deisem Jr., DDS?

The NPI number is 1093820557.

What is the phone number of Dr. Deisem?

The phone number listed for the practice location is (909) 591-0316.

Where is Dr. Deisem located?

12875 Mountain Ave, Chino, CA 91710-4556.

What is the taxonomy code for Dr. Deisem?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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