Provider Demographics
NPI:1003168345
Name:HEALTHY SMILES FOR EVERYONE DENTAL HYGIENE PRACTICE OF MARCIA ESPINOZA
Entity Type:Organization
Organization Name:HEALTHY SMILES FOR EVERYONE DENTAL HYGIENE PRACTICE OF MARCIA ESPINOZA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTAL HYGIENIST
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPINOZA
Authorized Official - Suffix:
Authorized Official - Credentials:RDHAP
Authorized Official - Phone:951-638-3896
Mailing Address - Street 1:375 CENTRAL AVE
Mailing Address - Street 2:58
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-6540
Mailing Address - Country:US
Mailing Address - Phone:951-638-3896
Mailing Address - Fax:
Practice Address - Street 1:375 CENTRAL AVE
Practice Address - Street 2:58
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-6540
Practice Address - Country:US
Practice Address - Phone:951-638-3896
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-10
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHAP 428302F00000X, 302R00000X, 305R00000X, 305S00000X, 320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No302F00000XManaged Care OrganizationsExclusive Provider Organization
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No305R00000XManaged Care OrganizationsPreferred Provider Organization
No305S00000XManaged Care OrganizationsPoint of Service