=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033032990
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANTHONY EVAN NARANJO DDS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/30/2026
-----------------------------------------------------
Last Update Date | 07/30/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 23RD DENTAL COMPANY 1591 GRIFFIN ROAD
-----------------------------------------------------
City | TWENTYNINE PALMS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92278
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-830-2117
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 978 REYNOSO PKWY
-----------------------------------------------------
City | BREA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92821-2376
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-944-5277
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 113439
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------