Provider Demographics
NPI:1700656790
Name:SIMPLICIANO, MARIA GABRIELLE ESGUERRA (DDS)
Entity Type:Individual
Prefix:
First Name:MARIA GABRIELLE
Middle Name:ESGUERRA
Last Name:SIMPLICIANO
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 1:569 E SHELLDRAKE CIR
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93730-1232
Mailing Address - Country:US
Mailing Address - Phone:206-934-9283
Mailing Address - Fax:
Practice Address - Street 1:16645 ROAD 26
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93638-0830
Practice Address - Country:US
Practice Address - Phone:559-664-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-02
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA109792122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist