Provider Demographics
NPI:1750574851
Name:REED, CARMELA SUNGLAO (DDS)
Entity type:Individual
Prefix:
First Name:CARMELA
Middle Name:SUNGLAO
Last Name:REED
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MARIA CARMELA
Other - Middle Name:SUNGLAO
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:2240 E PLAZA BLVD
Mailing Address - Street 2:SUITE Q
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-5164
Mailing Address - Country:US
Mailing Address - Phone:619-475-5767
Mailing Address - Fax:
Practice Address - Street 1:2240 E PLAZA BLVD
Practice Address - Street 2:SUITE Q
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-5164
Practice Address - Country:US
Practice Address - Phone:619-475-5767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA541951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice