Provider Demographics
NPI:1407016124
Name:MEREGILLANO, CHERYL ANGELA (DDS)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANGELA
Last Name:MEREGILLANO
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 1:27725 SANTA MARGARITA PKWY.
Mailing Address - Street 2:#261
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691
Mailing Address - Country:US
Mailing Address - Phone:949-597-2444
Mailing Address - Fax:949-597-2414
Practice Address - Street 1:27725 SANTA MARGARITA PKWY.
Practice Address - Street 2:#261
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691
Practice Address - Country:US
Practice Address - Phone:949-597-2444
Practice Address - Fax:949-597-2414
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA479521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice