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NPI Code Detail

MEDICARE: JOSE F. MIRANDA D.D.S., INC.

MEDICARE: JOSE F. MIRANDA D.D.S., INC.
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
1122300000XDentist41482CA

General Provider Information

NPI Number : 1659753267
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOSE F. MIRANDA D.D.S., INC.
Provider Business Mailing Address
First Line : 14676 PIPELINE AVE STE R
Second Line :
City : CHINO HILLS
State : CA
Zip : 91709-1918
Country : US
Telephone Number : 909-393-3180
Fax Number : 909-393-0372
Provider Business Practice Location Address
First Line : 14676 PIPELINE AVE STE R
Second Line :
City : CHINO HILLS
State : CA
Zip : 91709-1918
Country : US
Telephone Number : 909-393-3180
Fax Number : 909-393-0372
Authorized Official
Title or Position : OWNER/CEO
Name : DR. JOSE FERDINAND MIRANDA
Credential : D.M.D
Telephone Number : 909-393-3180
Provider Enumeration Date : 06/19/2015
Last Update Date : 08/19/2016

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Directions to “JOSE F. MIRANDA D.D.S., INC. ” Practice Location

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