Provider Demographics
NPI:1225164023
Name:ESTIPONA, MARIA GLORIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARIA GLORIA
Middle Name:
Last Name:ESTIPONA
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 1:410 TERRA MESA WAY
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-2440
Mailing Address - Country:US
Mailing Address - Phone:408-933-8330
Mailing Address - Fax:
Practice Address - Street 1:878 N HILLVIEW DR
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-4556
Practice Address - Country:US
Practice Address - Phone:408-933-8330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA490961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice