MIA LARISSA ANCHETA DDS A DENTAL CORPORATION NPI 1306398680

NPI Information

  • NPI: 1306398680
  • Provider Name: MIA LARISSA ANCHETA, DDS, A DENTAL CORPORATION
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Doing Business As: SAN ANGEL DENTAL, OFFICE OF MIA ANCHETA
  • Address: 8720 GARFIELD AVE STE 104
    SOUTH GATE, CA
    ZIP 90280
  • Phone: (562) 927-9050

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NPI Details

MIA LARISSA ANCHETA, DDS, A DENTAL CORPORATION is a dental clinic center in South Gate, CA. MIA LARISSA ANCHETA, DDS, A DENTAL CORPORATION NPI is 1306398680. The provider is registered as an organization entity type.
The provider Is Doing Business As San Angel Dental, Office Of Mia Ancheta.

The provider's business location address is:

8720 GARFIELD AVE STE 104
SOUTH GATE, CA
ZIP 90280-720
Phone: (562) 927-9050
Fax: (562) 927-9060

The provider's authorized official is Mia Larissa Ancheta .
The authorized official title is Ceo and has the following contact phone number (562) 927-9050.

The enumeration date for this NPI number is 11/2/2016 and was last updated on 10/25/2022.

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
1261QD0000XClinic/CenterDental47839CALIFORNIAYes

What is NPI?

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This page was last updated on: 3/30/2025

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