Provider Demographics
NPI:1033272596
Name:SIMBOL, DIANA JANE (DDS)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:JANE
Last Name:SIMBOL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-3531
Mailing Address - Country:US
Mailing Address - Phone:310-989-0689
Mailing Address - Fax:
Practice Address - Street 1:1403 LOMITA BLVD STE 306
Practice Address - Street 2:
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90710-2085
Practice Address - Country:US
Practice Address - Phone:310-530-1175
Practice Address - Fax:310-530-5852
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA469491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice