Provider Demographics
NPI:1558509075
Name:PIMENTEL, ALBERTO JR (DENTAL ASSITANT)
Entity Type:Individual
Prefix:
First Name:ALBERTO
Middle Name:
Last Name:PIMENTEL
Suffix:JR
Gender:M
Credentials:DENTAL ASSITANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 N NEPTUNE AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:CA
Mailing Address - Zip Code:90744-3135
Mailing Address - Country:US
Mailing Address - Phone:310-835-5223
Mailing Address - Fax:
Practice Address - Street 1:21229 HAWTHORNE BLVD STE A
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-5501
Practice Address - Country:US
Practice Address - Phone:310-792-5600
Practice Address - Fax:310-792-5628
Is Sole Proprietor?:No
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2684126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2684OtherDENTAL ASSISTANT