Provider Demographics
NPI:1194390708
Name:AGUILAR, ERIKA
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6151 KINGMAN AVE APT E
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-2377
Mailing Address - Country:US
Mailing Address - Phone:714-391-4305
Mailing Address - Fax:
Practice Address - Street 1:1000 SAN GABRIEL BLVD STE 200
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-4394
Practice Address - Country:US
Practice Address - Phone:323-724-0019
Practice Address - Fax:323-724-3539
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90655126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant