Provider Demographics
NPI:1902459977
Name:PEREZ-CELIS, ANGIE (DDS)
Entity type:Individual
Prefix:DR
First Name:ANGIE
Middle Name:
Last Name:PEREZ-CELIS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10945 BLUFFSIDE DR APT 411
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-4491
Mailing Address - Country:US
Mailing Address - Phone:818-312-6875
Mailing Address - Fax:
Practice Address - Street 1:1127 WILSHIRE BLVD STE 1504
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-4006
Practice Address - Country:US
Practice Address - Phone:213-201-1388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-18
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1858711223G0001X
CA1112171223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No1223G0001XDental ProvidersDentistGeneral Practice