Provider Demographics
NPI:1265652648
Name:ADRANEDA, NORA PEDRAJA (DMD)
Entity Type:Individual
Prefix:DR
First Name:NORA
Middle Name:PEDRAJA
Last Name:ADRANEDA
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 1:3875 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 805
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-3205
Mailing Address - Country:US
Mailing Address - Phone:213-387-3917
Mailing Address - Fax:213-387-3972
Practice Address - Street 1:3875 WILSHIRE BLVD
Practice Address - Street 2:SUITE 805
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-3205
Practice Address - Country:US
Practice Address - Phone:213-387-3917
Practice Address - Fax:213-387-3972
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA371511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice