Provider Demographics
NPI:1285767970
Name:DIMAPILIS, JUDEMAR SACULINGGAN (DMD)
Entity type:Individual
Prefix:DR
First Name:JUDEMAR
Middle Name:SACULINGGAN
Last Name:DIMAPILIS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5565 GROSSMONT CENTER DR STE 209 BLDG 1
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-3022
Mailing Address - Country:US
Mailing Address - Phone:619-469-4185
Mailing Address - Fax:619-469-3166
Practice Address - Street 1:5565 GROSSMONT CENTER DR STE 209 BLDG 1
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3022
Practice Address - Country:US
Practice Address - Phone:619-469-4185
Practice Address - Fax:619-469-3166
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA507451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice