Provider Demographics
NPI:1669671210
Name:DR. JUNE CINCO SIRON,DDS,INC.
Entity Type:Organization
Organization Name:DR. JUNE CINCO SIRON,DDS,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUNE
Authorized Official - Middle Name:CINCO
Authorized Official - Last Name:SIRON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-935-5583
Mailing Address - Street 1:912 S VICTORIA AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90019-1922
Mailing Address - Country:US
Mailing Address - Phone:323-935-5583
Mailing Address - Fax:323-935-5583
Practice Address - Street 1:912 S VICTORIA AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019-1922
Practice Address - Country:US
Practice Address - Phone:323-935-5583
Practice Address - Fax:323-935-5583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA426121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty