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General NPI Number Information
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NPI Number | 1649165440
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Entity Type | Organization
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Legal Business Name | DIMA SUMMAKIA PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 06/11/2025
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 999 N TUSTIN AVE STE 205
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City | SANTA ANA
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State | CA
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Zip | 92705-6506
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Country | US
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Telephone | 901-336-2367
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Fax |
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Provider Business Mailing Address
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Address Line | 3214 E WOODBINE RD
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City | ORANGE
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State | CA
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Zip | 92867-2091
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Country | US
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Telephone | 901-336-2367
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. DIMA SUMMAKIA
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Credential | DDS
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Telephone | 901-336-2367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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