Provider Demographics
NPI:1225553894
Name:NAVARRO, MARINA ROSE DE CASTRO (DMD)
Entity Type:Individual
Prefix:
First Name:MARINA ROSE
Middle Name:DE CASTRO
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5008 GLENVIEW ST
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-7404
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7864 VAN NUYS BLVD
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91402-6069
Practice Address - Country:US
Practice Address - Phone:818-989-2400
Practice Address - Fax:818-989-2457
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-04
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57079122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist