Provider Demographics
NPI:1023867405
Name:LEAL PINILLA, SANDRA GUIOMAR (DDS)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:GUIOMAR
Last Name:LEAL PINILLA
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 1:701 W IMPERIAL HWY
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-7073
Mailing Address - Country:US
Mailing Address - Phone:562-455-0367
Mailing Address - Fax:
Practice Address - Street 1:2800 N MAIN ST UNIT 1010
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-6076
Practice Address - Country:US
Practice Address - Phone:714-862-1210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1047771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice