Michelle Espejo, R.D.A.

Individual provider Active NPI Dental Assistant · Alpine, CA

NPI 1992078455 · NPPES record last updated Feb 14, 2012

Key facts

NPI
1992078455
Entity type
Individual (NPI type 1)
Primary specialty
Dental Assistant 126800000X
License
73392 (CA)
Practice address
4058 Willows Rd
Alpine, CA 91901-1668
Phone
(619) 445-1188
NPI assigned
Feb 14, 2012
Sex
Female
Sole proprietor
No

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
73392CAMDAmbulatory Care Pharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Assistant 126800000X 73392 CA Yes

Addresses

Primary practice location

4058 Willows Rd
Alpine, CA 91901-1668

Mailing address

168 D St # B
Chula Vista, CA 91910-1942
Phone (619) 201-4123

Other providers in Alpine, CA

All providers in Alpine, CA · Dental Assistant in California

Sources for this page

Verify at the official NPI Registry.