Inne S Oen, DDS

Individual provider Active NPI General Practice Dentistry · Hacienda HTS, CA

NPI 1992867519 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1992867519
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
B28213 (CA)
Practice address
2219 S Hacienda Blvd. Suite210
Hacienda HTS, CA 91745-4610
Phone
(626) 330-6599
Fax
(626) 333-9360
NPI assigned
Dec 14, 2006
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
B28213CAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X B28213 CA Yes

Addresses

Primary practice location

2219 S Hacienda Blvd. Suite210
Hacienda HTS, CA 91745-4610

Mailing address

1837 14 Vallecito Dr
Hacienda HTS, CA 91745-3345
Phone (626) 330-6599

Other identifiers

IdentifierTypeStateIssuer
B28213-02MedicaidCA

Other providers in Hacienda HTS, CA

All providers in Hacienda HTS, CA · General Practice Dentistry in California

Sources for this page

Verify at the official NPI Registry.