Healthcare Provider Details

I. General information

NPI: 1568603223
Provider Name (Legal Business Name): DANA MARIA CARABULEA D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2009
Last Update Date: 03/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10721 EQUESTRIAN DR
NORTH TUSTIN CA
92705-2427
US

IV. Provider business mailing address

10721 EQUESTRIAN DR
NORTH TUSTIN CA
92705-2427
US

V. Phone/Fax

Practice location:
  • Phone: 714-943-8357
  • Fax: 714-417-9821
Mailing address:
  • Phone: 714-943-8357
  • Fax: 714-417-9821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number43585
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: