Healthcare Provider Details

I. General information

NPI: 1447177381
Provider Name (Legal Business Name): ESSENTIAL LOO FAMILY DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14323 RAMONA BLVD
BALDWIN PARK CA
91706-3242
US

IV. Provider business mailing address

14323 RAMONA BLVD
BALDWIN PARK CA
91706-3242
US

V. Phone/Fax

Practice location:
  • Phone: 626-856-8160
  • Fax: 626-856-3616
Mailing address:
  • Phone: 626-856-8160
  • Fax: 626-856-3616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: MILAGROS ANDRADA LOO
Title or Position: OWNER
Credential: DDS
Phone: 626-962-8160