Healthcare Provider Details

I. General information

NPI: 1730368168
Provider Name (Legal Business Name): DEYANIRA SANCHEZ D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2007
Last Update Date: 03/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 W GONZALES RD
OXNARD CA
93036-9004
US

IV. Provider business mailing address

4246 SALTILLO ST
WOODLAND HILLS CA
91364-5929
US

V. Phone/Fax

Practice location:
  • Phone: 805-983-0100
  • Fax:
Mailing address:
  • Phone: 818-884-8294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number56497
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: