Healthcare Provider Details

I. General information

NPI: 1477489383
Provider Name (Legal Business Name): MILLOT DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3075 FIRESTONE BLVD
SOUTH GATE CA
90280-2739
US

IV. Provider business mailing address

3075 FIRESTONE BLVD
SOUTH GATE CA
90280-2739
US

V. Phone/Fax

Practice location:
  • Phone: 323-567-2530
  • Fax: 310-388-1088
Mailing address:
  • Phone: 323-567-2530
  • Fax: 310-388-1088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ANTEMIO MILLOT
Title or Position: DENTIST
Credential:
Phone: 323-582-6938