Provider Demographics
NPI:1508023557
Name:NIEHOFF, ANA ADLER (DDS)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:ADLER
Last Name:NIEHOFF
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 1:1590 ROSECRANS AVE STE N
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-3723
Mailing Address - Country:US
Mailing Address - Phone:310-643-6994
Mailing Address - Fax:310-643-0127
Practice Address - Street 1:1590 ROSECRANS AVE STE N
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-3723
Practice Address - Country:US
Practice Address - Phone:310-643-6994
Practice Address - Fax:310-643-0127
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA438811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice