NPI 1134616394

Jason Derek Miranda, RDAOAP

Practitioner Dental Assistant Lancaster, CA

Practice location

Address: 5033 W Avenue L10 APT 15, Lancaster, CA 93536-3681
Phone: (661) 709-0637

Registered specialties

Dental Assistant Primary

Dental Providers Taxonomy 126800000X Licence RDA84892 (CA)

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Registry record

NPI: 1134616394
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 Apr 2018
Record last updated: 13 Apr 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.