Provider Demographics
NPI:1710198130
Name:SONIN, NINA (DDS)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:SONIN
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 1:3043 FOOTHILL BLVD STE 5
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-2773
Mailing Address - Country:US
Mailing Address - Phone:818-542-3039
Mailing Address - Fax:818-542-3097
Practice Address - Street 1:3043 FOOTHILL BLVD STE 5
Practice Address - Street 2:
Practice Address - City:LA CRESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214-2773
Practice Address - Country:US
Practice Address - Phone:818-542-3039
Practice Address - Fax:818-542-3097
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA434951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice