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General NPI Number Information
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NPI Number | 1598028417
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Entity Type | Individual
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Provider Name | FLYNNE V WEINGARTEN D.D.S
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Gender | Female
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Dates
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Enumeration Date | 06/18/2012
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Last Update Date | 04/26/2024
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Provider Practice Location Address
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Address Line | 12660 RIVERSIDE DR STE 210
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City | VALLEY VILLAGE
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State | CA
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Zip | 91607-3430
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Country | US
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Telephone | 818-284-6018
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Fax |
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Provider Business Mailing Address
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Address Line | 12660 RIVERSIDE DR STE 210
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City | VALLEY VILLAGE
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State | CA
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Zip | 91607-3430
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Country | US
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Telephone | 574-303-2533
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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 | DI02503800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 101046
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License Number State | CA
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