Basic Information
| Provider Information | |||||||||
| NPI: | 1003000175 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REYES-VASQUEZ | ||||||||
| FirstName: | BELINDA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.D.S. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 4727 SILVER TIP DR | ||||||||
| Address2: | |||||||||
| City: | WHITTIER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906011763 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6263785315 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 322 N AZUSA AVE STE 202 | ||||||||
| Address2: | |||||||||
| City: | LA PUENTE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917444648 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6265810800 | ||||||||
| FaxNumber: | 6265810591 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2007 | ||||||||
| LastUpdateDate: | 01/23/2020 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 01/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 56153 | CA | Y | Dental Providers | Dentist |
No ID Information.