Provider Demographics
NPI:1699825588
Name:MINDEL, ALBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:
Last Name:MINDEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6581 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-2728
Mailing Address - Country:US
Mailing Address - Phone:818-353-1123
Mailing Address - Fax:
Practice Address - Street 1:6581 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:TUJUNGA
Practice Address - State:CA
Practice Address - Zip Code:91042-2728
Practice Address - Country:US
Practice Address - Phone:818-353-1123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADN0336321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice