Provider Demographics
NPI:1043417090
Name:AGUILAR, SIRINA S (DDS)
Entity Type:Individual
Prefix:DR
First Name:SIRINA
Middle Name:S
Last Name:AGUILAR
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 1:13707 COASTAL COURT
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:CA
Mailing Address - Zip Code:95386
Mailing Address - Country:US
Mailing Address - Phone:209-874-4010
Mailing Address - Fax:209-394-8361
Practice Address - Street 1:1112 MAIN STREET
Practice Address - Street 2:
Practice Address - City:LIVINGTON
Practice Address - State:CA
Practice Address - Zip Code:95334
Practice Address - Country:US
Practice Address - Phone:209-394-8383
Practice Address - Fax:209-394-8361
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48783122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist