Provider Demographics
NPI:1972049906
Name:NAVEJAS CARPIO, EMILIANO (DDS)
Entity Type:Individual
Prefix:
First Name:EMILIANO
Middle Name:
Last Name:NAVEJAS CARPIO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2484 VISTA WAY STE B
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-5682
Mailing Address - Country:US
Mailing Address - Phone:760-439-0334
Mailing Address - Fax:
Practice Address - Street 1:2484 VISTA WAY STE B
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-5682
Practice Address - Country:US
Practice Address - Phone:760-439-0334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-14
Last Update Date:2017-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100769122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist