Provider Demographics
NPI:1215117304
Name:ESTRADA, ELIZABETH MAY (DDS)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MAY
Last Name:ESTRADA
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 1:7300 TOPANGA CANYON BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-3333
Mailing Address - Country:US
Mailing Address - Phone:747-444-9090
Mailing Address - Fax:
Practice Address - Street 1:7300 TOPANGA CANYON BLVD STE 6
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-3333
Practice Address - Country:US
Practice Address - Phone:747-444-9090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-06
Last Update Date:2021-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA562721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice