Provider Demographics
NPI:1588703300
Name:MARIA PILAR BERNARDO DDS INC
Entity type:Organization
Organization Name:MARIA PILAR BERNARDO DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:PILAR
Authorized Official - Last Name:BERNARDO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-660-2011
Mailing Address - Street 1:4331 W SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-2111
Mailing Address - Country:US
Mailing Address - Phone:323-660-2011
Mailing Address - Fax:323-660-3788
Practice Address - Street 1:4331 W SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-2111
Practice Address - Country:US
Practice Address - Phone:323-660-2011
Practice Address - Fax:323-660-3788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA505711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG94065 01OtherDENTI CAL