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General NPI Number Information
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NPI Number | 1902459977
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Entity Type | Individual
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Provider Name | ANGIE PEREZ-CELIS DDS
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Gender | Female
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Dates
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Enumeration Date | 07/18/2019
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 1127 WILSHIRE BLVD STE 1504
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City | LOS ANGELES
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State | CA
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Zip | 90017-4006
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Country | US
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Telephone | 213-201-1388
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Fax |
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Provider Business Mailing Address
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Address Line | 10945 BLUFFSIDE DR APT 411
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City | STUDIO CITY
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State | CA
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Zip | 91604-4491
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Country | US
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Telephone | 818-312-6875
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN185871
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 111217
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License Number State | CA
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