MEDICARE: HELEN MAYARI SILVA RDA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	126800000X	Dental Assistant	70598	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	70598	OTHER	CA	DENTAL PROVIDER (RDA)

General Provider Information

NPI Number	:	1558796557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HELEN MAYARI SILVA RDA

Provider Business Mailing Address
First Line	:	3917 1/2 MELROSE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90029-3681
Country	:	US
Telephone Number	:	323-652-8822
Fax Number	:

Provider Business Practice Location Address
First Line	:	3917 1/2 MELROSE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90029-3681
Country	:	US
Telephone Number	:	323-652-8822
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2013
Last Update Date	:	09/09/2013

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Directions to “ HELEN MAYARI SILVA RDA” Practice Location

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