Healthcare Provider Details

I. General information

NPI: 1760517395
Provider Name (Legal Business Name): ZENAIDA ELVIRA SILVA CUISIA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 08/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3257 CAMINO DE LOS COCHES STE 304
CARLSBAD CA
92009-8974
US

IV. Provider business mailing address

3257 CAMINO DE LOS COCHES STE 304
CARLSBAD CA
92009-8974
US

V. Phone/Fax

Practice location:
  • Phone: 760-633-1131
  • Fax:
Mailing address:
  • Phone: 760-633-1131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number49739
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: