Healthcare Provider Details

I. General information

NPI: 1851424501
Provider Name (Legal Business Name): MARIA ELOISA B ESPIRITU DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIA ELOISA B ESPIRITU DDS

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2295 FIELDSTONE DRIVE SUITE 240
LINCOLN CA
95648
US

IV. Provider business mailing address

4035 SHADYBROOK COURT
GRANITE BAY CA
95746
US

V. Phone/Fax

Practice location:
  • Phone: 916-543-8800
  • Fax: 916-543-8950
Mailing address:
  • Phone: 916-791-2748
  • Fax: 916-791-2748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number50137
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: