Provider Demographics
NPI:1588704969
Name:REYES, SHIELA LIMENSE (DDS)
Entity type:Individual
Prefix:DR
First Name:SHIELA
Middle Name:LIMENSE
Last Name:REYES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6771 BEACH BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-3470
Mailing Address - Country:US
Mailing Address - Phone:714-670-2273
Mailing Address - Fax:714-522-2929
Practice Address - Street 1:6771 BEACH BLVD STE A
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-3470
Practice Address - Country:US
Practice Address - Phone:714-670-2273
Practice Address - Fax:714-522-2929
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA440691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice