1861989758 NPI number — DOWNEY FAMILY COSMETIC DENTISTRY

Table of content: (NPI 1861989758)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861989758 NPI number — DOWNEY FAMILY COSMETIC DENTISTRY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DOWNEY FAMILY COSMETIC DENTISTRY
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:
1861989758
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/15/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9426 SOMERSET BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLFLOWER
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90706-3009
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-925-3735
Provider Business Mailing Address Fax Number:
562-381-9150

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9212 LAKEWOOD BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DOWNEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90280
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-320-8414
Provider Business Practice Location Address Fax Number:
562-381-9150
Provider Enumeration Date:
04/17/2018

Additional Information

Authorized Official

Authorized Official Last Name:
GONZALEZ
Authorized Official First Name:
CRISTINA
Authorized Official Middle Name:
Authorized Official Title or Position:
BILLER
Authorized Official Telephone Number:
323-768-1422

Provider Taxonomy Codes

  • Taxonomy code: 261QD0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com