Provider Demographics
NPI:1104217199
Name:MARIA ELENA TAPIA DDS A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:MARIA ELENA TAPIA DDS A PROFESSIONAL CORPORATION
Other - Org Name:DENSTISTRY BY DESIGN PACIFIC PALISADES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ELENA
Authorized Official - Last Name:TAPIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-454-0912
Mailing Address - Street 1:881 ALMA REAL DR APT 205A
Mailing Address - Street 2:
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-5048
Mailing Address - Country:US
Mailing Address - Phone:310-454-0912
Mailing Address - Fax:424-272-9860
Practice Address - Street 1:881 ALMA REAL DR APT 205A
Practice Address - Street 2:
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272-5048
Practice Address - Country:US
Practice Address - Phone:310-454-0912
Practice Address - Fax:424-272-9860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-11
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49226122300000X
CA511541223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty