Provider Demographics
NPI:1003257536
Name:PLEITEZ, ERIK I (DMD)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:I
Last Name:PLEITEZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10244 CANOGA AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-0988
Mailing Address - Country:US
Mailing Address - Phone:818-517-9551
Mailing Address - Fax:
Practice Address - Street 1:10244 CANOGA AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-0988
Practice Address - Country:US
Practice Address - Phone:818-517-9551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA624691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice