Provider Demographics
NPI:1841601192
Name:GOMEZ, ERIKA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERIKA
Middle Name:
Last Name:GOMEZ
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 1:560 W MAIN ST STE C315
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3374
Mailing Address - Country:US
Mailing Address - Phone:626-319-5896
Mailing Address - Fax:
Practice Address - Street 1:3737 MARTIN LUTHER KING BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262-3524
Practice Address - Country:US
Practice Address - Phone:626-319-5896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-08
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63381122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist