Provider Demographics
NPI:1144398470
Name:BESIN, MARIA NENEFIL LIBOR (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARIA NENEFIL
Middle Name:LIBOR
Last Name:BESIN
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 1:37 HARKNESS AVE
Mailing Address - Street 2:UNIT # 1
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-2035
Mailing Address - Country:US
Mailing Address - Phone:323-572-5678
Mailing Address - Fax:
Practice Address - Street 1:11725 W WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-5917
Practice Address - Country:US
Practice Address - Phone:310-391-7173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53760122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA122300000XOtherDENTIST