Provider Demographics
NPI:1609949635
Name:AMISOLA, SHEILA THERESE AQUINO (DMD)
Entity type:Individual
Prefix:
First Name:SHEILA THERESE
Middle Name:AQUINO
Last Name:AMISOLA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19823 VISTA GRANDE DR.
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709
Mailing Address - Country:US
Mailing Address - Phone:909-979-4779
Mailing Address - Fax:
Practice Address - Street 1:1021 E HOLT AVE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-5720
Practice Address - Country:US
Practice Address - Phone:909-979-4779
Practice Address - Fax:909-622-0400
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA507231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice