Healthcare Provider Details

I. General information

NPI: 1306786280
Provider Name (Legal Business Name): MAYRA MUNGUIA DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E REDLANDS BLVD STE 134
REDLANDS CA
92373-4723
US

IV. Provider business mailing address

101 E REDLANDS BLVD STE 134
REDLANDS CA
92373-4723
US

V. Phone/Fax

Practice location:
  • Phone: 909-335-3631
  • Fax:
Mailing address:
  • Phone: 909-335-3631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. MAYRA MUNGUIA
Title or Position: OWNER DENTIST
Credential: DDS
Phone: 626-705-8681