Provider Demographics
NPI:1245356237
Name:ENOJADO, SANDRA VALERIO (DDS)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:VALERIO
Last Name:ENOJADO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11695 THE PLAZA
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650
Mailing Address - Country:US
Mailing Address - Phone:562-929-3702
Mailing Address - Fax:562-929-3702
Practice Address - Street 1:11695 THE PLZ
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-3930
Practice Address - Country:US
Practice Address - Phone:562-929-3702
Practice Address - Fax:562-929-3702
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA405821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice