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General NPI Number Information
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NPI Number | 1508531104
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Entity Type | Individual
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Provider Name | KEVIN HOFILENA OBANA DDS
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Gender | Male
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Dates
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Enumeration Date | 08/16/2021
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 1725 W 6TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90017-1000
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Country | US
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Telephone | 213-413-5151
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Fax |
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Provider Business Mailing Address
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Address Line | 525 S YNEZ AVE
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City | MONTEREY PARK
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State | CA
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Zip | 91754-3832
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Country | US
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Telephone | 313-338-8255
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 2901601120
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 112247
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License Number State | CA
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