Individual provider Active NPI

Angel Joy Malanyaon Estrada, RDHAP

  • Dental Hygienist
  • Canyon Country, CA
National Provider Identifier
1235700451
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
30613 Issued in CA
Practice address
17414 Winter Pine Way
Canyon Country, CA 91387-6877
Phone
(818) 205-5307
NPI assigned
Jul 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 30613 CA Primary

Addresses

Primary practice location

17414 Winter Pine Way
Canyon Country, CA 91387-6877

Mailing address

17414 Winter Pine Way
Canyon Country, CA 91387-6877
Phone (818) 205-5307

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
30613CAMDDental Hygienist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1235700451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17414 WINTER PINE WAY",
            "city": "CANYON COUNTRY",
            "state": "CA",
            "postal_code": "913876877",
            "telephone_number": "818-205-5307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17414 WINTER PINE WAY",
            "city": "CANYON COUNTRY",
            "state": "CA",
            "postal_code": "913876877",
            "telephone_number": "818-205-5307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTRADA",
        "first_name": "ANGEL JOY",
        "middle_name": "MALANYAON",
        "name_prefix": "Ms.",
        "credential": "RDHAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-08",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "30613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canyon Country, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.