Provider Demographics
NPI:1568848190
Name:AGUILAR RIOS, ETHEL NOEMI (DDS)
Entity Type:Individual
Prefix:DR
First Name:ETHEL
Middle Name:NOEMI
Last Name:AGUILAR RIOS
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 1:231 DALI AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94041-1690
Mailing Address - Country:US
Mailing Address - Phone:530-354-2251
Mailing Address - Fax:
Practice Address - Street 1:1429 GRANT RD # B
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-3250
Practice Address - Country:US
Practice Address - Phone:530-961-9194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-05
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64799122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist