| Dental Spa Of Artesia | |
|
11960 Artesia Blvd Suite 200 Artesia CA 90701 | |
| (562) 468-1168 | |
| (562) 468-1158 |
| Full Name | Dental Spa Of Artesia |
|---|---|
| Speciality | Clinic/Center |
| Location | 11960 Artesia Blvd Suite 200, Artesia, California |
| Authorized Official Name and Position | Erika Zambrano (OFFICE MANAGER) |
| Authorized Official Contact | 5624681168 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Spa Of Artesia 11960 Artesia Blvd Ste 200 Artesia CA 90701-4093 Ph: (562) 468-1168 | Dental Spa Of Artesia 11960 Artesia Blvd Suite 200 Artesia CA 90701 Ph: (562) 468-1168 |
| NPI Number | 1891214037 |
|---|---|
| Provider Enumeration Date | 09/19/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 5890185151 |
|---|---|
| Medicare Enrollment ID | O20211201001604 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891214037 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (California) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | David S Kang |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1518171594 PECOS PAC ID: 6709276066 Enrollment ID: I20220106000757 |
| Provider Name | David W. Cho |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1306955455 PECOS PAC ID: 2961892229 Enrollment ID: I20220106002239 |
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