Provider Demographics
NPI:1417172537
Name:ALSAYEH, MARIA ELDA (DDS)
Entity Type:Individual
Prefix:MRS
First Name:MARIA ELDA
Middle Name:
Last Name:ALSAYEH
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:PO BOX 420883
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92142
Mailing Address - Country:US
Mailing Address - Phone:619-593-1183
Mailing Address - Fax:619-593-7211
Practice Address - Street 1:772 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020
Practice Address - Country:US
Practice Address - Phone:619-590-1888
Practice Address - Fax:619-593-7211
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA373821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB37382OtherMEDI CAL
PA979382OtherUNITED CONCORDIA
CA516924OtherMEDI CAL PIN NUMBER
CA903721OtherDELTA HEP PIN NUMBER