Provider Demographics
NPI:1073637021
Name:ONA, IRENE DELFIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:IRENE
Middle Name:DELFIN
Last Name:ONA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12438 RUNNINGCREEK LN
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-2048
Mailing Address - Country:US
Mailing Address - Phone:562-802-0142
Mailing Address - Fax:
Practice Address - Street 1:22211 AVALON BLVD
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-3359
Practice Address - Country:US
Practice Address - Phone:310-835-9010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA506631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice