Provider Demographics
NPI:1023149846
Name:MOLINGIT, PRESCILLA JUNI (DENTIST DMD)
Entity type:Individual
Prefix:MRS
First Name:PRESCILLA
Middle Name:JUNI
Last Name:MOLINGIT
Suffix:
Gender:F
Credentials:DENTIST DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 NO VERMONT AVE
Mailing Address - Street 2:SUITE # I
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-6022
Mailing Address - Country:US
Mailing Address - Phone:323-665-7279
Mailing Address - Fax:323-665-9844
Practice Address - Street 1:1321 NO VERMONT AVE
Practice Address - Street 2:SUITE # I
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6022
Practice Address - Country:US
Practice Address - Phone:323-665-7279
Practice Address - Fax:323-665-9844
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA331271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB3312701OtherMEDICAL