Provider Demographics
NPI:1124031794
Name:MICHEL, ANA (DDS)
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:
Last Name:MICHEL
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 1:3058 E GAGE AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-4432
Mailing Address - Country:US
Mailing Address - Phone:323-581-2603
Mailing Address - Fax:323-581-6217
Practice Address - Street 1:3058 E GAGE AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-4432
Practice Address - Country:US
Practice Address - Phone:323-581-2603
Practice Address - Fax:323-581-6217
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA366791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice