Provider Demographics
NPI:1265557037
Name:ESPINOZA, MICHELLE M (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:M
Last Name:ESPINOZA
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 1:3737 MORAGA AVE.
Mailing Address - Street 2:STE: B-414
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117
Mailing Address - Country:US
Mailing Address - Phone:858-272-5550
Mailing Address - Fax:858-272-5551
Practice Address - Street 1:3737 MORAGA AVE.
Practice Address - Street 2:STE: B-414
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117
Practice Address - Country:US
Practice Address - Phone:858-272-5550
Practice Address - Fax:858-272-5551
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48258122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist