Provider Demographics
NPI:1205490364
Name:TAPIA, ARACELI (RDA)
Entity type:Individual
Prefix:MRS
First Name:ARACELI
Middle Name:
Last Name:TAPIA
Suffix:
Gender:F
Credentials:RDA
Other - Prefix:MRS
Other - First Name:ARACELI
Other - Middle Name:
Other - Last Name:TAPIA DE CEBALLOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MARIA ARACELI TAPIA
Mailing Address - Street 1:11023 LORENE ST
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90601-2609
Mailing Address - Country:US
Mailing Address - Phone:562-714-4335
Mailing Address - Fax:
Practice Address - Street 1:8381 LA PALMA AVE STE B
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-3271
Practice Address - Country:US
Practice Address - Phone:714-602-1467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARDA91976126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant