Provider Demographics
NPI:1174603542
Name:REICHEL, STANTON JAY (DDS)
Entity type:Individual
Prefix:DR
First Name:STANTON
Middle Name:JAY
Last Name:REICHEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 W LOMITA BLVD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4974
Mailing Address - Country:US
Mailing Address - Phone:310-326-5063
Mailing Address - Fax:310-326-7295
Practice Address - Street 1:3400 W LOMITA BLVD
Practice Address - Street 2:SUITE 207
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4974
Practice Address - Country:US
Practice Address - Phone:310-326-5063
Practice Address - Fax:310-326-7295
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA141601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice