Provider Demographics
NPI:1639389489
Name:ADELYNIA, AZITA (DDS)
Entity Type:Individual
Prefix:DR
First Name:AZITA
Middle Name:
Last Name:ADELYNIA
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 1:8170 E SANTA ANA CANYON RD
Mailing Address - Street 2:SUITE 192
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92808-1106
Mailing Address - Country:US
Mailing Address - Phone:714-283-0815
Mailing Address - Fax:714-283-0847
Practice Address - Street 1:8170 E SANTA ANA CANYON RD
Practice Address - Street 2:SUITE 192
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92808-1106
Practice Address - Country:US
Practice Address - Phone:714-283-0815
Practice Address - Fax:714-283-0847
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38789122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist