Doris Jean Amaya

Individual provider Active NPI Dental Assistant · Artesia, CA

NPI 1033301072 · NPPES record last updated Aug 14, 2007

Key facts

NPI
1033301072
Entity type
Individual (NPI type 1)
Primary specialty
Dental Assistant 126800000X
License
27254 (CA)
Practice address
11664 178TH St Apt a
Artesia, CA 90701-3881
Phone
(562) 402-8513
NPI assigned
Aug 14, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
27254CAMDDental Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Assistant 126800000X 27254 CA Yes

Addresses

Primary practice location

11664 178TH St Apt a
Artesia, CA 90701-3881

Mailing address

11664 178TH St Apt a
Artesia, CA 90701-3881
Phone (562) 402-8513

Other providers in Artesia, CA

All providers in Artesia, CA · Dental Assistant in California

Sources for this page

Verify at the official NPI Registry.