Provider Demographics
NPI:1083403364
Name:GIANNETTI, MAYA C (DDS)
Entity type:Individual
Prefix:DR
First Name:MAYA
Middle Name:C
Last Name:GIANNETTI
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2757 12TH ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95818-2941
Mailing Address - Country:US
Mailing Address - Phone:530-574-5417
Mailing Address - Fax:
Practice Address - Street 1:2650 21ST ST STE 8
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95818-2539
Practice Address - Country:US
Practice Address - Phone:213-395-5242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-03
Last Update Date:2025-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1087981223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics