Provider Demographics
NPI:1548534613
Name:ARIPEZ, ELAINE (RDA)
Entity type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:
Last Name:ARIPEZ
Suffix:
Gender:F
Credentials:RDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2442 CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-2913
Mailing Address - Country:US
Mailing Address - Phone:562-810-8364
Mailing Address - Fax:
Practice Address - Street 1:6255 W SUNSET BLVD FL 21
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-7422
Practice Address - Country:US
Practice Address - Phone:323-462-6869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-06
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58699126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant