Provider Demographics
NPI:1942959416
Name:YVETTE CARRILLO DDS MS INC
Entity Type:Organization
Organization Name:YVETTE CARRILLO DDS MS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR. / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YVETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRILLO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:858-869-9234
Mailing Address - Street 1:5797 MISSION CENTER RD # 202
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-4300
Mailing Address - Country:US
Mailing Address - Phone:909-961-7700
Mailing Address - Fax:
Practice Address - Street 1:3023 BUNKER HILL ST STE 105
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-5706
Practice Address - Country:US
Practice Address - Phone:858-869-9234
Practice Address - Fax:619-374-2849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty