1679890545 NPI number — SUELDO AND PERLECHE DENTAL INC

Table of content: (NPI 1679890545)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679890545 NPI number — SUELDO AND PERLECHE DENTAL INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUELDO AND PERLECHE DENTAL INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679890545
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/30/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
85 RAMONA EXPY
Provider Second Line Business Mailing Address:
SUITE #7
Provider Business Mailing Address City Name:
PERRIS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92571-7014
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
951-943-7171
Provider Business Mailing Address Fax Number:
951-943-6366

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
85 RAMONA EXPY
Provider Second Line Business Practice Location Address:
SUITE #7
Provider Business Practice Location Address City Name:
PERRIS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92571-7014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-943-7171
Provider Business Practice Location Address Fax Number:
951-943-6366
Provider Enumeration Date:
04/30/2010

Additional Information

Authorized Official

Authorized Official Last Name:
SUELDO
Authorized Official First Name:
ALBERTO
Authorized Official Middle Name:
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
951-943-7171

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  53733 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1223G0001X , with the licence number: 55135 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1144406349 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1710197876 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com