Provider Demographics
NPI:1831255413
Name:FALABELLA, JUAN PABLO (DDS)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:PABLO
Last Name:FALABELLA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29378 VIA MILAGRO
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91354-1574
Mailing Address - Country:US
Mailing Address - Phone:661-257-8437
Mailing Address - Fax:
Practice Address - Street 1:1701 TRUMAN ST
Practice Address - Street 2:B-C
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-3100
Practice Address - Country:US
Practice Address - Phone:818-837-1660
Practice Address - Fax:818-837-1662
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA493101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG94054-01OtherDENTI-CAL