Provider Demographics
NPI:1104965953
Name:PINEDA, CLARA ANGELA (DDS)
Entity type:Individual
Prefix:MRS
First Name:CLARA
Middle Name:ANGELA
Last Name:PINEDA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 W RAY ROAD
Mailing Address - Street 2:STE A 5
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233
Mailing Address - Country:US
Mailing Address - Phone:480-821-4868
Mailing Address - Fax:
Practice Address - Street 1:707 W RAY ROAD
Practice Address - Street 2:STE A 5
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233
Practice Address - Country:US
Practice Address - Phone:480-821-4868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3997122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist