Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0221X | Pediatric Dentist | DTP 415 | FL |
Y | 1223P0221X | Pediatric Dentist | SP256 | CA |
NPI | 1043277551 |
---|---|
Provider Name | Dr. Daniela Rodrigues Pereira Da Silva |
First Address | Los Angeles, CA 90095-0405 |
Second Address | Los Angeles, CA 90095-0405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 28/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
075846900 | (05) | FL |
BS 9136929 | DEA (01) | FL |