| Dr. Lourdes S. Aquino Dental Corp. | |
|
14435 Sherman Way Unit 107 Van Nuys CA 91405-2331 | |
| (818) 785-7498 | |
| (818) 785-7789 |
| Full Name | Dr. Lourdes S. Aquino Dental Corp. |
|---|---|
| Speciality | Dentist |
| Location | 14435 Sherman Way, Van Nuys, California |
| Authorized Official Name and Position | Lourdes Santos Aquino (OWNER/ DENTIST) |
| Authorized Official Contact | 8187857498 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Lourdes S. Aquino Dental Corp. 14435 Sherman Way Unit 107 Van Nuys CA 91405-2331 Ph: (818) 785-7498 | Dr. Lourdes S. Aquino Dental Corp. 14435 Sherman Way Unit 107 Van Nuys CA 91405-2331 Ph: (818) 785-7498 |
| NPI Number | 1669862371 |
|---|---|
| Provider Enumeration Date | 02/02/2015 |
| Last Update Date | 08/14/2021 |
| Medicare PECOS PAC ID | 8123452950 |
|---|---|
| Medicare Enrollment ID | O20200102001199 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669862371 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 50435 (California) | Primary |
| Provider Name | Lourdes Santos Aquino |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1962550137 PECOS PAC ID: 9032543863 Enrollment ID: I20200102001459 |
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