Juarez-Mata, Elvia
Juarez-Mata, Elvia is an individual health care provider with primary practice located at 82204 Us Highway 111 , Indio CA 92201-5630. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Juarez-Mata, Elvia can be contacted via phone (760) 775-5552.Contact Information
Primary practice address
82204 Us Highway 111
Indio CA 92201-5630
Phone: (760) 775-5552
Fax: (760) 775-5002
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 41625 | California |
Profile Details
| NPI number | 1689710626 |
|---|---|
| LBN Legal business name | Juarez-Mata, Elvia |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 29th, 2007 |
| Last updated | Nov 21st, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689710626 | NPPES |
| California | MEDICAID | 1003982638 |
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