Provider Demographics
NPI:1316471188
Name:ANA M GAMA DDS, INC
Entity type:Organization
Organization Name:ANA M GAMA DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GAMA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-723-2008
Mailing Address - Street 1:6201 WHITTIER BLVD
Mailing Address - Street 2:STE 11-12
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90022-4505
Mailing Address - Country:US
Mailing Address - Phone:323-723-2008
Mailing Address - Fax:844-528-6765
Practice Address - Street 1:6201 WHITTIER BLVD
Practice Address - Street 2:STE 11-12
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-4505
Practice Address - Country:US
Practice Address - Phone:323-723-2008
Practice Address - Fax:844-528-6765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48269122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty