Provider Demographics
NPI:1750800736
Name:NAANAA, MARIA (DDS)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:NAANAA
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 1:2002 OLIVEGATE LN
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95136-3213
Mailing Address - Country:US
Mailing Address - Phone:408-529-7894
Mailing Address - Fax:
Practice Address - Street 1:7970 LANDER AVE STE A
Practice Address - Street 2:
Practice Address - City:HILMAR
Practice Address - State:CA
Practice Address - Zip Code:95324-8350
Practice Address - Country:US
Practice Address - Phone:209-262-1816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-12
Last Update Date:2017-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101642122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist