MRS. MITRA BOLBOLAN MACMILLAN D.D.S NPI 1497964514

NPI Information

NPI: 1497964514
Provider Name: MRS. MITRA BOLBOLAN MACMILLAN, D.D.S
Classification: Dentist - 1223P0300X
Entity Type: Individual

Specialization: Periodontics

Address:
4264 GREEN RIVER RD
CORONA, CA
ZIP 92880
Phone: (951) 340-0200
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MRS. Mitra Bolbolan Macmillan, D.D.S is a periodontics dentist in Corona, CA. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. MRS. Mitra Bolbolan Macmillan, D.D.S NPI is 1497964514. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4264 GREEN RIVER RD
CORONA, CA
ZIP 92880-669
Phone: (951) 340-0200
Fax: (951) 278-9858

The enumeration date for this NPI number is 5/22/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223P0300X	Dentist	Periodontics	42808	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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