Provider Demographics
NPI:1972703122
Name:PINTO, ANGEL JAVIER (DDS)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:JAVIER
Last Name:PINTO
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 1:8942 CRIOLLO CT
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-3292
Mailing Address - Country:US
Mailing Address - Phone:831-207-5072
Mailing Address - Fax:916-594-9146
Practice Address - Street 1:925 SECRET RIVER DR STE J
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-3465
Practice Address - Country:US
Practice Address - Phone:916-594-9474
Practice Address - Fax:916-594-9146
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52103122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABP8768307OtherDEA