Provider Demographics
NPI:1922996453
Name:PEREZ-INIGO MORALES, JOSEFINA
Entity type:Individual
Prefix:
First Name:JOSEFINA
Middle Name:
Last Name:PEREZ-INIGO MORALES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1446 DONHILL DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-2216
Mailing Address - Country:US
Mailing Address - Phone:786-216-2394
Mailing Address - Fax:
Practice Address - Street 1:3130 S SEPULVEDA BLVD STE D
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-4214
Practice Address - Country:US
Practice Address - Phone:310-268-0646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA110807122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist