MEDICARE: CARLOS DA SILVA 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
1	122300000X	Dentist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	43434	OTHER	CA	DENTIST

General Provider Information

NPI Number	:	1740359181
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARLOS DA SILVA D.D.S INC.

Provider Business Mailing Address
First Line	:	1306 FAIRPLAIN AVE
Second Line	:
City	:	WHITTIER
State	:	CA
Zip	:	90601-1024
Country	:	US
Telephone Number	:	626-336-0448
Fax Number	:

Provider Business Practice Location Address
First Line	:	11042 VALLEY MALL
Second Line	:
City	:	EL MONTE
State	:	CA
Zip	:	91731-2617
Country	:	US
Telephone Number	:	626-442-0699
Fax Number	:	626-442-0885

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CARLOS TALTIVIO DA SILVA
Credential	:	D.D.S.
Telephone Number	:	626-442-0699

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	08/22/2020

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