Provider Demographics
NPI:1881915106
Name:MARIA LILIBETH L. JOSE, DDS, INC.
Entity type:Organization
Organization Name:MARIA LILIBETH L. JOSE, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA LILIBETH
Authorized Official - Middle Name:LICAYAN
Authorized Official - Last Name:JOSE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-690-9896
Mailing Address - Street 1:26953 MISSION BLVD
Mailing Address - Street 2:SUITE J
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-4156
Mailing Address - Country:US
Mailing Address - Phone:510-690-9896
Mailing Address - Fax:510-690-9895
Practice Address - Street 1:26953 MISSION BLVD
Practice Address - Street 2:SUITE J
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-4156
Practice Address - Country:US
Practice Address - Phone:510-690-9896
Practice Address - Fax:510-690-9895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-21
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA404491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty