Provider Demographics
NPI:1407942659
Name:FERREIRA, SERGIO L (DDS)
Entity Type:Individual
Prefix:MR
First Name:SERGIO
Middle Name:L
Last Name:FERREIRA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 PACIFIC COAST HWY APT 120
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-3948
Mailing Address - Country:US
Mailing Address - Phone:714-969-3756
Mailing Address - Fax:
Practice Address - Street 1:3930 S BRISTOL ST STE 201
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-7431
Practice Address - Country:US
Practice Address - Phone:714-546-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48262122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist