Provider Demographics
NPI:1063613875
Name:SILVERA, ANDREIA MINASIAN (DDS)
Entity type:Individual
Prefix:DR
First Name:ANDREIA
Middle Name:MINASIAN
Last Name:SILVERA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ANDREIA
Other - Middle Name:
Other - Last Name:MINASIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2080 CENTURY PARK E
Mailing Address - Street 2:#1003
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067-2001
Mailing Address - Country:US
Mailing Address - Phone:310-553-0809
Mailing Address - Fax:310-839-7833
Practice Address - Street 1:2080 CENTURY PARK E STE 1003
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067-2013
Practice Address - Country:US
Practice Address - Phone:310-553-0809
Practice Address - Fax:310-839-7833
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA362631223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDental Anesthesiology