San Angel Dental Management Company

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

47839 Issued in CA

Legal business name

SAN ANGEL DENTAL MANAGEMENT COMPANY

Practice address

8720 Garfield Ave
Suite #104
South Gate, CA 90280-3720

Phone

(562) 927-9050

Fax

(562) 927-9060

NPI assigned

Jan 24, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Mia Larissa Ancheta, DDS

Title

Partner

Phone

(562) 927-9050

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1295827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295827200000",
    "number": "1922303809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8720 GARFIELD AVE",
            "address_2": "SUITE #104",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902803720",
            "telephone_number": "562-927-9050",
            "fax_number": "562-927-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8720 GARFIELD AVE",
            "address_2": "SUITE #104",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902803720",
            "telephone_number": "562-927-9050",
            "fax_number": "562-927-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN ANGEL DENTAL MANAGEMENT COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-24",
        "last_updated": "2011-01-24",
        "status": "A",
        "authorized_official_last_name": "ANCHETA",
        "authorized_official_first_name": "MIA",
        "authorized_official_middle_name": "LARISSA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "562-927-9050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": "CA",
            "license": "47839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Public Health Dentistry in South Gate, CA
• Providers in South Gate, CA by specialty
• Public Health Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2011; 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.