Provider Demographics
NPI:1134272503
Name:TERMINI, LAUREL NEVARTE (DMD)
Entity type:Individual
Prefix:DR
First Name:LAUREL
Middle Name:NEVARTE
Last Name:TERMINI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:LAUREL
Other - Middle Name:NEVARTE
Other - Last Name:ADRIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:1977 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001-3528
Mailing Address - Country:US
Mailing Address - Phone:626-798-4915
Mailing Address - Fax:
Practice Address - Street 1:3820 SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-2408
Practice Address - Country:US
Practice Address - Phone:310-792-5200
Practice Address - Fax:310-792-5201
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA373791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice