Provider Demographics
NPI:1518497643
Name:CARLOS, SYLVIA OLIVIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:OLIVIA
Last Name:CARLOS
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 1:3612 FLORISTA ST
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-2423
Mailing Address - Country:US
Mailing Address - Phone:562-598-4207
Mailing Address - Fax:
Practice Address - Street 1:22032 EL PASEO STE 200
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688-3947
Practice Address - Country:US
Practice Address - Phone:949-589-3344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-12
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32989122300000X
CA1062891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist