Provider Demographics
NPI:1831287069
Name:VILKAS-STOCKUS, ALMA MARIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALMA
Middle Name:MARIA
Last Name:VILKAS-STOCKUS
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 1:1346 FOOTHILL BLVD STE 302
Mailing Address - Street 2:
Mailing Address - City:LA CANADA
Mailing Address - State:CA
Mailing Address - Zip Code:91011-2152
Mailing Address - Country:US
Mailing Address - Phone:818-248-5593
Mailing Address - Fax:818-790-1561
Practice Address - Street 1:1346 FOOTHILL BLVD STE 302
Practice Address - Street 2:
Practice Address - City:LA CANADA
Practice Address - State:CA
Practice Address - Zip Code:91011
Practice Address - Country:US
Practice Address - Phone:818-248-5593
Practice Address - Fax:818-790-1561
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA289991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB28999Medicaid