Provider Demographics
NPI:1982690368
Name:MILANEZ, ANTHONY J (DDS)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:J
Last Name:MILANEZ
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 1:5757 WILSHIRE BLVD
Mailing Address - Street 2:350
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-5810
Mailing Address - Country:US
Mailing Address - Phone:323-931-9019
Mailing Address - Fax:323-931-9034
Practice Address - Street 1:5757 WILSHIRE BLVD
Practice Address - Street 2:350
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-5810
Practice Address - Country:US
Practice Address - Phone:323-931-9019
Practice Address - Fax:323-931-9034
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-21
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47290122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist