Provider Demographics
NPI:1912464728
Name:R. ESPINOZA D.D.S. INC
Entity type:Organization
Organization Name:R. ESPINOZA D.D.S. INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPINOZA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-717-9066
Mailing Address - Street 1:20173 SATICOY ST
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91306-2506
Mailing Address - Country:US
Mailing Address - Phone:818-717-9066
Mailing Address - Fax:
Practice Address - Street 1:2315 KUEHNER DR STE 116
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-3971
Practice Address - Country:US
Practice Address - Phone:877-654-0082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-28
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty