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NPI Code Detail

MEDICARE: COMMUNITY DENTAL SERVICES

MEDICARE: COMMUNITY DENTAL SERVICES
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
1122300000XDentist

General Provider Information

NPI Number : 1720158124
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY DENTAL SERVICES
Provider Business Mailing Address
First Line : 2 MACARTHUR PL
Second Line : SUITE 700
City : SANTA ANA
State : CA
Zip : 92707-5924
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1440 W MANCHESTER AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90047-5422
Country : US
Telephone Number : 323-753-1141
Fax Number : 323-753-3046
Authorized Official
Title or Position : CONTRACT SUPERVISOR
Name : MRS. ELAINE M SALCIDO
Credential :
Telephone Number : 714-708-5308
Provider Enumeration Date : 11/09/2006
Last Update Date : 08/22/2020

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Directions to “COMMUNITY DENTAL SERVICES ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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