Provider Demographics
NPI:1427688894
Name:NADIA K. PEREZ L
Entity type:Organization
Organization Name:NADIA K. PEREZ L
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:KARINA
Authorized Official - Last Name:PEREZ L
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:760-886-8558
Mailing Address - Street 1:P.O. BOX 9008
Mailing Address - Street 2:
Mailing Address - City:CALEXICO
Mailing Address - State:CA
Mailing Address - Zip Code:92232
Mailing Address - Country:US
Mailing Address - Phone:760-886-8558
Mailing Address - Fax:858-430-3143
Practice Address - Street 1:CALLE 7MA #8074, ZONA CENTRO
Practice Address - Street 2:ZONA CENTRO
Practice Address - City:MEXICALI
Practice Address - State:CA
Practice Address - Zip Code:21100
Practice Address - Country:US
Practice Address - Phone:760-886-8558
Practice Address - Fax:858-430-3143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-24
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty