Healthcare Provider Details

I. General information

NPI: 1043277551
Provider Name (Legal Business Name): DANIELA RODRIGUES PEREIRA DA SILVA D.D.S., M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 03/07/2023
Certification Date: 02/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10833 LECONTE AVE CHS 23-020A
LOS ANGELES CA
90095-0405
US

IV. Provider business mailing address

10833 LECONTE AVE CHS 23-020A
LOS ANGELES CA
90095-0405
US

V. Phone/Fax

Practice location:
  • Phone: 310-206-5118
  • Fax: 352-392-8195
Mailing address:
  • Phone: 310-206-5118
  • Fax: 352-392-8195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDTP 415
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberSP256
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: