Provider Demographics
NPI:1134241870
Name:FILIPPELLI, GREGG S (DDS)
Entity type:Individual
Prefix:
First Name:GREGG
Middle Name:S
Last Name:FILIPPELLI
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 1:10630 TOWN CENTER DR
Mailing Address - Street 2:#125
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-6805
Mailing Address - Country:US
Mailing Address - Phone:909-483-3131
Mailing Address - Fax:909-483-3136
Practice Address - Street 1:10630 TOWN CENTER DR
Practice Address - Street 2:#125
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-6805
Practice Address - Country:US
Practice Address - Phone:909-483-3131
Practice Address - Fax:909-483-3136
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0349561223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics