Provider Demographics
NPI:1457448060
Name:UY, CARMEN MILLADO (DDS)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:MILLADO
Last Name:UY
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 1:320 N VERDUGO RD
Mailing Address - Street 2:#100
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-5238
Mailing Address - Country:US
Mailing Address - Phone:818-548-0608
Mailing Address - Fax:818-548-0648
Practice Address - Street 1:320 N VERDUGO RD
Practice Address - Street 2:#100
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-5238
Practice Address - Country:US
Practice Address - Phone:818-548-0608
Practice Address - Fax:818-548-0648
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA496941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG9370901OtherDENTI CAL
CAG9370901OtherMEDICAL