Provider Demographics
NPI:1902192578
Name:GITA AMINLOO, RDHAP, INC.
Entity Type:Organization
Organization Name:GITA AMINLOO, RDHAP, INC.
Other - Org Name:SOCAL DENTAL HYGIENE GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:GITA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMINLOO
Authorized Official - Suffix:
Authorized Official - Credentials:RDHAP
Authorized Official - Phone:949-341-5588
Mailing Address - Street 1:12155 WYNE CT
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92782-1185
Mailing Address - Country:US
Mailing Address - Phone:949-341-5588
Mailing Address - Fax:949-341-5522
Practice Address - Street 1:12155 WYNE CT
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92782-1185
Practice Address - Country:US
Practice Address - Phone:949-341-5588
Practice Address - Fax:949-341-5522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-22
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA348124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty