Provider Demographics
NPI:1609082148
Name:ABANILLA, BELENDA VILLARUEL (DMD)
Entity type:Individual
Prefix:DR
First Name:BELENDA
Middle Name:VILLARUEL
Last Name:ABANILLA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3017 E FLORENCE AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-5827
Mailing Address - Country:US
Mailing Address - Phone:323-584-1171
Mailing Address - Fax:323-584-0307
Practice Address - Street 1:3017 E FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-5827
Practice Address - Country:US
Practice Address - Phone:323-584-1171
Practice Address - Fax:323-584-0307
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39223122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist