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General NPI Number Information
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NPI Number | 1518846252
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Entity Type | Organization
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Legal Business Name | REYNA-BLANCO DENTAL CORPORATION
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Dates
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Enumeration Date | 08/28/2025
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 12405 VENTURA BLVD
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City | STUDIO CITY
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State | CA
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Zip | 91604-2407
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Country | US
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Telephone | 818-518-9763
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Fax |
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Provider Business Mailing Address
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Address Line | 1147 N CLARK ST APT 105
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90069-2044
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Country | US
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Telephone | 509-699-8882
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST / CEO
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Name | DR. OSCAR HUMBERTO REYNA-BLANCO
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Credential | DDS, MMSC
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Telephone | 509-699-8882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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