Provider Demographics
NPI:1104374206
Name:DINEA-BERCI, EMILIA LAVINIA (DDS)
Entity Type:Individual
Prefix:
First Name:EMILIA
Middle Name:LAVINIA
Last Name:DINEA-BERCI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:LAVINIA
Other - Middle Name:
Other - Last Name:BERCI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:3634 WHITNEY AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-3128
Mailing Address - Country:US
Mailing Address - Phone:916-782-2010
Mailing Address - Fax:
Practice Address - Street 1:1259 PLEASANT GROVE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-6974
Practice Address - Country:US
Practice Address - Phone:916-782-2010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS100602122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADDS100602OtherDENTAL BOARD OF CALIFORNIA