Provider Demographics
NPI:1891900221
Name:PLEYTO, XERES DESIREE AZAULA (DDS)
Entity Type:Individual
Prefix:DR
First Name:XERES DESIREE
Middle Name:AZAULA
Last Name:PLEYTO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:XERES DESIREE
Other - Middle Name:GAVIRA
Other - Last Name:AZAULA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:5168 N BURWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91722-1007
Mailing Address - Country:US
Mailing Address - Phone:626-383-6756
Mailing Address - Fax:
Practice Address - Street 1:16029 ARROW HWY
Practice Address - Street 2:SUITE E
Practice Address - City:IRWINDALE
Practice Address - State:CA
Practice Address - Zip Code:91706-2066
Practice Address - Country:US
Practice Address - Phone:626-962-7200
Practice Address - Fax:626-962-7220
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55397122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist