Provider Demographics
NPI:1528225067
Name:SILVA, SANDI E (DDS)
Entity Type:Individual
Prefix:DR
First Name:SANDI
Middle Name:E
Last Name:SILVA
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 1:13422 NEWPORT AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3746
Mailing Address - Country:US
Mailing Address - Phone:714-544-5883
Mailing Address - Fax:714-544-5884
Practice Address - Street 1:13422 NEWPORT AVE
Practice Address - Street 2:SUITE A
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3746
Practice Address - Country:US
Practice Address - Phone:714-544-5883
Practice Address - Fax:714-544-5884
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA432471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice