Provider Demographics
NPI:1598989436
Name:ARTEAGA, ANAMARIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANAMARIA
Middle Name:
Last Name:ARTEAGA
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 1:1427 GREENPORT AVE
Mailing Address - Street 2:
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-2123
Mailing Address - Country:US
Mailing Address - Phone:626-810-7490
Mailing Address - Fax:
Practice Address - Street 1:14607 RAMONA BLVD STE B
Practice Address - Street 2:
Practice Address - City:BALDWIN PARK
Practice Address - State:CA
Practice Address - Zip Code:91706-3465
Practice Address - Country:US
Practice Address - Phone:626-960-5108
Practice Address - Fax:626-337-1318
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48222122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD-48222Medicaid