Provider Demographics
NPI:1457688830
Name:B. CHANGELA D.D.S. INC.
Entity Type:Organization
Organization Name:B. CHANGELA D.D.S. INC.
Other - Org Name:DENTAL CARE OF CHINO HILLS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ASTRID
Authorized Official - Middle Name:E
Authorized Official - Last Name:AROSTEGUI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-839-1004
Mailing Address - Street 1:3280 CHINO HILLS PARK WAY
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709
Mailing Address - Country:US
Mailing Address - Phone:909-839-1004
Mailing Address - Fax:
Practice Address - Street 1:3280 CHINO HILLS PARK WAY
Practice Address - Street 2:SUITE 4
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709
Practice Address - Country:US
Practice Address - Phone:909-839-1004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49487261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental