Provider Demographics
NPI:1861989758
Name:DOWNEY FAMILY COSMETIC DENTISTRY
Entity type:Organization
Organization Name:DOWNEY FAMILY COSMETIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-768-1422
Mailing Address - Street 1:9426 SOMERSET BLVD
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-3009
Mailing Address - Country:US
Mailing Address - Phone:562-925-3735
Mailing Address - Fax:562-381-9150
Practice Address - Street 1:9212 LAKEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90280
Practice Address - Country:US
Practice Address - Phone:562-320-8414
Practice Address - Fax:562-381-9150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-17
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental