Provider Demographics
NPI:1568928984
Name:COMPEAN D.D.S. A PROFESSIONAL CORP.
Entity Type:Organization
Organization Name:COMPEAN D.D.S. A PROFESSIONAL CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:TERI
Authorized Official - Middle Name:
Authorized Official - Last Name:MEJIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-924-1523
Mailing Address - Street 1:10945 SOUTH ST STE 200A
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-5366
Mailing Address - Country:US
Mailing Address - Phone:562-924-1523
Mailing Address - Fax:562-365-6870
Practice Address - Street 1:10945 SOUTH ST STE 200A
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-5366
Practice Address - Country:US
Practice Address - Phone:562-924-1523
Practice Address - Fax:562-365-6870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty