Provider Demographics
NPI:1073727780
Name:DE LOS REYES, MARIA CHUAPOCO (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:CHUAPOCO
Last Name:DE LOS REYES
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 1:160 SONOMA CT
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-2552
Mailing Address - Country:US
Mailing Address - Phone:408-239-9200
Mailing Address - Fax:888-343-3817
Practice Address - Street 1:170 KING ST STE 105
Practice Address - Street 2:SUITE C
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-4914
Practice Address - Country:US
Practice Address - Phone:415-347-3817
Practice Address - Fax:888-343-3817
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37643122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist