Provider Demographics
NPI:1912027467
Name:ABJELINA, ANGELLI ABRACOSA (DDS)
Entity Type:Individual
Prefix:
First Name:ANGELLI
Middle Name:ABRACOSA
Last Name:ABJELINA
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 1:21615 BERENDO AVE
Mailing Address - Street 2:SUITE#100
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-1800
Mailing Address - Country:US
Mailing Address - Phone:310-320-2307
Mailing Address - Fax:310-320-2948
Practice Address - Street 1:21615 BERENDO AVE
Practice Address - Street 2:SUITE#100
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-1800
Practice Address - Country:US
Practice Address - Phone:310-320-2307
Practice Address - Fax:310-320-2948
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38954122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist