Individual provider · NPI-1

Isaiah Darian Vasquez, RDA

Dental Assistant · Lynwood, CA

NPI number1861038713
StatusActive
Last updated in NPPESNov 25, 2019

Details

NPI
1861038713
Entity type
Individual (NPI-1)
Name
Isaiah Darian Vasquez
Credential
RDA
Sex
Male
Sole proprietor
No
Enumeration date
Nov 25, 2019
Last updated
Nov 25, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
126800000X Dental Assistant93763CAYes

Practice location

9910 Long Beach Blvd Ste A
Lynwood, CA 90262-1561

Phone 323-538-2002

Mailing address

8020 Birchcrest Rd Apt E104
Downey, CA 90240-2107

Phone 562-565-7479

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Dental Assistant providers in Lynwood, CA