Provider Demographics
NPI:1295740876
Name:BELDA, MICHAEL MAX (DDS)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:MAX
Last Name:BELDA
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 1:6318 E SANTA ANA CNYN RD
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92807
Mailing Address - Country:US
Mailing Address - Phone:714-921-9992
Mailing Address - Fax:714-921-4234
Practice Address - Street 1:6318 E SANTA ANA CNYN RD
Practice Address - Street 2:
Practice Address - City:ANAHEIM HILLS
Practice Address - State:CA
Practice Address - Zip Code:92807
Practice Address - Country:US
Practice Address - Phone:714-921-9992
Practice Address - Fax:714-921-4234
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39132122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist