Provider Demographics
NPI:1477675668
Name:BILLEDO, PRINCESITA ASUNCION (DDS)
Entity Type:Individual
Prefix:DR
First Name:PRINCESITA
Middle Name:ASUNCION
Last Name:BILLEDO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MRS
Other - First Name:PRINCESITA
Other - Middle Name:A
Other - Last Name:BILLEDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:1755 S MOUNTAIN AVE
Mailing Address - Street 2:STE A
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-5972
Mailing Address - Country:US
Mailing Address - Phone:909-460-7776
Mailing Address - Fax:909-460-7677
Practice Address - Street 1:1755 S MOUNTAIN AVE
Practice Address - Street 2:STE A
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-5972
Practice Address - Country:US
Practice Address - Phone:909-460-7776
Practice Address - Fax:909-460-7677
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA434201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice