| Los Cerritos Dental Practice | |
|
18510 Gridley Rd Artesia CA 90701 | |
| (323) 560-1318 | |
| Not Available |
| Full Name | Los Cerritos Dental Practice |
|---|---|
| Speciality | Clinic/Center |
| Location | 18510 Gridley Rd, Artesia, California |
| Authorized Official Name and Position | Trinh Thi Bui (PRESIDENT) |
| Authorized Official Contact | 7144966389 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Los Cerritos Dental Practice 8470 Pebble Beach Dr Buena Park CA 90621-1054 Ph: (714) 496-6389 | Los Cerritos Dental Practice 18510 Gridley Rd Artesia CA 90701 Ph: (323) 560-1318 |
| NPI Number | 1588121248 |
|---|---|
| Provider Enumeration Date | 02/28/2019 |
| Last Update Date | 05/01/2020 |
| Medicare PECOS PAC ID | 7416387451 |
|---|---|
| Medicare Enrollment ID | O20200415002279 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588121248 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| 261QS0112X | Clinic/center - Oral And Maxillofacial Surgery | (* (Not Available)) | Secondary |
| Provider Name | Trinh Bui |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1568527760 PECOS PAC ID: 5698105633 Enrollment ID: I20200415002670 |
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