Provider Demographics
NPI:1609005602
Name:PARADO, THERESE JAMIE (DDS)
Entity Type:Individual
Prefix:
First Name:THERESE JAMIE
Middle Name:
Last Name:PARADO
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 1:14722 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-1505
Mailing Address - Country:US
Mailing Address - Phone:310-973-5437
Mailing Address - Fax:
Practice Address - Street 1:14722 HAWTHORNE BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:LAWNDALE
Practice Address - State:CA
Practice Address - Zip Code:90260-1505
Practice Address - Country:US
Practice Address - Phone:310-973-5437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-10
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA601661223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry