Provider Demographics
NPI:1124186341
Name:SEQUEIRA, ERIKA M (DDS)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:M
Last Name:SEQUEIRA
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 1:18625 QUAIL HILL RD CORONA CA 92881
Mailing Address - Street 2:
Mailing Address - City:CARONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881
Mailing Address - Country:US
Mailing Address - Phone:951-515-2639
Mailing Address - Fax:909-465-6867
Practice Address - Street 1:13161 PEYTON DR
Practice Address - Street 2:SUITE B
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709
Practice Address - Country:US
Practice Address - Phone:951-278-8006
Practice Address - Fax:909-465-6867
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50529122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist