Provider Demographics
NPI:1992247423
Name:SEMPE, MARIA GUADALUPE (RDA)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:GUADALUPE
Last Name:SEMPE
Suffix:
Gender:F
Credentials:RDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 INDIAN HILL BLVD
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-3728
Mailing Address - Country:US
Mailing Address - Phone:909-482-4500
Mailing Address - Fax:909-482-4502
Practice Address - Street 1:1640 INDIAN HILL BLVD
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-3728
Practice Address - Country:US
Practice Address - Phone:909-482-4500
Practice Address - Fax:909-482-4502
Is Sole Proprietor?:No
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35528126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant