1285804237 NPI number — DR. MARIA REGINA PADILLA ESTRELLA DDS, MS

Table of content: DR. MARIA REGINA PADILLA ESTRELLA DDS, MS (NPI 1285804237)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285804237 NPI number — DR. MARIA REGINA PADILLA ESTRELLA DDS, MS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ESTRELLA
Provider First Name:
MARIA REGINA
Provider Middle Name:
PADILLA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS, MS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ESTRELLA
Provider Other First Name:
NINNA
Provider Other Middle Name:
PADILLA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DDS, MS
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1285804237
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/31/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1011 N UNIVERSITY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANN ARBOR
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48109-1078
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-763-7820
Provider Business Mailing Address Fax Number:
734-615-7294

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1011 N UNIVERSITY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANN ARBOR
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48109-1078
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-763-7820
Provider Business Practice Location Address Fax Number:
734-615-7294
Provider Enumeration Date:
03/06/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  2901019733 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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