DR. HARLEY ALBERT DEISEM DDS NPI 1093820557

NPI Information

  • NPI: 1093820557
  • Provider Name: DR. HARLEY ALBERT DEISEM, DDS
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Individual
  • Address: 12875 MOUNTAIN AVE
    CHINO, CA
    ZIP 91710
  • Phone: (909) 591-0316

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NPI Details

DR. Harley Albert Deisem, DDS is a general practice dentist in Chino, CA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Harley Albert Deisem, DDS NPI is 1093820557. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

12875 MOUNTAIN AVE
CHINO, CA
ZIP 91710-556
Phone: (909) 591-0316
Fax: (909) 628-4823

The enumeration date for this NPI number is 8/21/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice029698CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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