Provider Demographics
NPI:1801403712
Name:MARIA Z. CARBAJAL, DDS, INC
Entity Type:Organization
Organization Name:MARIA Z. CARBAJAL, DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ZAIDA
Authorized Official - Last Name:CARBAJAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-235-4148
Mailing Address - Street 1:4581 SAINT ANDREWS DR
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-7967
Mailing Address - Country:US
Mailing Address - Phone:818-324-1495
Mailing Address - Fax:
Practice Address - Street 1:611 N EUCLID AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-3223
Practice Address - Country:US
Practice Address - Phone:909-235-4148
Practice Address - Fax:909-235-4636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty