Provider Demographics
NPI:1548489974
Name:ECHEVERRIA, JULIETA YANIRA (DDS)
Entity type:Individual
Prefix:DR
First Name:JULIETA
Middle Name:YANIRA
Last Name:ECHEVERRIA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24875 ALESSANDRO BLVD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-6106
Mailing Address - Country:US
Mailing Address - Phone:951-247-6640
Mailing Address - Fax:951-247-6678
Practice Address - Street 1:24875 ALESSANDRO BLVD
Practice Address - Street 2:SUITE 8
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-6106
Practice Address - Country:US
Practice Address - Phone:951-247-6640
Practice Address - Fax:951-247-6678
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47073122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist