Healthcare Provider Details

I. General information

NPI: 1992627459
Provider Name (Legal Business Name): ENABLE DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3723 SAN GABRIEL RIVER PKWY STE E
PICO RIVERA CA
90660-1456
US

IV. Provider business mailing address

3723 SAN GABRIEL RIVER PKWY STE E
PICO RIVERA CA
90660-1456
US

V. Phone/Fax

Practice location:
  • Phone: 866-988-4504
  • Fax:
Mailing address:
  • Phone: 866-988-4504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State

VIII. Authorized Official

Name: NAYELI ALICIA GALLEGOS
Title or Position: REGISTERED DENTAL HYGIENIST
Credential: RDH
Phone: 562-889-2688