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General NPI Number Information
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NPI Number | 1114872520
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Entity Type | Individual
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Provider Name | MICHELLE AVILA PIMENTEL
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Gender | Female
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Dates
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Enumeration Date | 03/02/2026
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Last Update Date | 03/02/2026
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Provider Practice Location Address
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Address Line | 550 DEEP VALLEY DR STE 345
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City | ROLLING HILLS ESTATES
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State | CA
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Zip | 90274-7603
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Country | US
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Telephone | 310-377-4551
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Fax |
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Provider Business Mailing Address
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Address Line | 6366 GOTHAM ST
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City | BELL GARDENS
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State | CA
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Zip | 90201-5622
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Country | US
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Telephone | 562-641-1784
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 126800000X
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Taxonomy Name | Dental Assistant
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License Number | 103945
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License Number State | CA
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