Provider Demographics
NPI:1396626651
Name:BELTRAN, MARIA DOLORES
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:DOLORES
Last Name:BELTRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6918 WILCOX AVE APT G
Mailing Address - Street 2:
Mailing Address - City:BELL
Mailing Address - State:CA
Mailing Address - Zip Code:90201-3844
Mailing Address - Country:US
Mailing Address - Phone:323-749-1058
Mailing Address - Fax:
Practice Address - Street 1:9825 LONG BEACH BLVD STE A
Practice Address - Street 2:
Practice Address - City:SOUTH GATE
Practice Address - State:CA
Practice Address - Zip Code:90280-4100
Practice Address - Country:US
Practice Address - Phone:323-249-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36309124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist