Provider Demographics
NPI:1942436654
Name:REFELA, JANE ALFONSE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:ALFONSE
Last Name:REFELA
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 1:9250 SUNLAND BLVD
Mailing Address - Street 2:UNIT 6
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-2062
Mailing Address - Country:US
Mailing Address - Phone:818-731-1614
Mailing Address - Fax:
Practice Address - Street 1:831 E HUNTINGTON DR
Practice Address - Street 2:SUITE 201
Practice Address - City:MONROVIA
Practice Address - State:CA
Practice Address - Zip Code:91016-3612
Practice Address - Country:US
Practice Address - Phone:626-359-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-09
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59625122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist