Provider Demographics
NPI:1861653545
Name:CORIA, JAYMIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAYMIE
Middle Name:
Last Name:CORIA
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 1:302 E PALM DR STE A
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-3233
Mailing Address - Country:US
Mailing Address - Phone:171-452-8205
Mailing Address - Fax:714-528-1472
Practice Address - Street 1:302 E PALM DR STE A
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-3233
Practice Address - Country:US
Practice Address - Phone:714-528-2053
Practice Address - Fax:714-528-1472
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52545122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist