Provider Demographics
NPI:1588076244
Name:ESTHER M. MONIAGA D.D.S.INC.
Entity type:Organization
Organization Name:ESTHER M. MONIAGA D.D.S.INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:M
Authorized Official - Last Name:MONIAGA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-396-7774
Mailing Address - Street 1:23341 GOLDEN SPRINGS DR STE 206
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-2054
Mailing Address - Country:US
Mailing Address - Phone:909-396-7774
Mailing Address - Fax:909-396-8874
Practice Address - Street 1:23341 GOLDEN SPRINGS DR STE 206
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-2054
Practice Address - Country:US
Practice Address - Phone:909-396-7774
Practice Address - Fax:909-396-8874
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ESTHER M. MONIAGA D.D.S.INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-05-28
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36623122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty