Provider Demographics
NPI:1487020293
Name:LAREZ, ANINA (DDS)
Entity Type:Individual
Prefix:
First Name:ANINA
Middle Name:
Last Name:LAREZ
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 1:3481 E CURRY ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90805-3815
Mailing Address - Country:US
Mailing Address - Phone:562-552-1381
Mailing Address - Fax:
Practice Address - Street 1:3481 E CURRY ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90805-3815
Practice Address - Country:US
Practice Address - Phone:562-552-1381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-15
Last Update Date:2015-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA648381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice