| Angel Smile Dental Groups | |
|
7300 Topanga Canyon Blvd Suite #6 Canoga Park CA 91303-3333 | |
| (818) 884-4422 | |
| (818) 884-4773 |
| Full Name | Angel Smile Dental Groups |
|---|---|
| Speciality | Dentist |
| Location | 7300 Topanga Canyon Blvd, Canoga Park, California |
| Authorized Official Name and Position | Alejandra Taveras (DENTIST) |
| Authorized Official Contact | 8188844422 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Angel Smile Dental Groups 7300 Topanga Canyon Blvd Suite #6 Canoga Park CA 91303-3333 Ph: (818) 884-4422 | Angel Smile Dental Groups 7300 Topanga Canyon Blvd Suite #6 Canoga Park CA 91303-3333 Ph: (818) 884-4422 |
| NPI Number | 1861798639 |
|---|---|
| Provider Enumeration Date | 01/26/2011 |
| Last Update Date | 01/26/2011 |
| Medicare PECOS PAC ID | 9335573625 |
|---|---|
| Medicare Enrollment ID | O20191219000385 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861798639 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 58328 (California) | Primary |
| Provider Name | Juan Manuel Mejia |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1609022490 PECOS PAC ID: 1153755442 Enrollment ID: I20191219000595 |
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