Provider Demographics
NPI:1609051580
Name:SARAH DANCEL-ATENDIDO D.M.D. INC.
Entity type:Organization
Organization Name:SARAH DANCEL-ATENDIDO D.M.D. INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:DANCEL-ATENDIDO
Authorized Official - Suffix:
Authorized Official - Credentials:D,MD
Authorized Official - Phone:626-964-4777
Mailing Address - Street 1:882 MARGARET LN
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789
Mailing Address - Country:US
Mailing Address - Phone:626-964-4777
Mailing Address - Fax:
Practice Address - Street 1:2707 E. VALLEY BLVD., SUITE 200
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91792
Practice Address - Country:US
Practice Address - Phone:626-964-4777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SARAH DANCEL-ATENDIDO D.M.D. INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA467741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty