MEDICARE: RALPH SANCHEZ JR., D.D.S., INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C0511026	OTHER	CA	DRIVERS LICENSE

General Provider Information

NPI Number	:	1669067757
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RALPH SANCHEZ JR., D.D.S., INC.

Provider Business Mailing Address
First Line	:	7500 SEVILLE AVE
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-6028
Country	:	US
Telephone Number	:	323-585-0153
Fax Number	:	323-585-9287

Provider Business Practice Location Address
First Line	:	7500 SEVILLE AVE
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-6028
Country	:	US
Telephone Number	:	323-585-0153
Fax Number	:	323-585-9287

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. RALPH SANCHEZ JR.
Credential	:	D.D.S.
Telephone Number	:	323-585-0153

Provider Enumeration Date	:	03/02/2021
Last Update Date	:	03/02/2021

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Directions to “RALPH SANCHEZ JR., D.D.S., INC. ” Practice Location

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