Miya, Darron Ikari
Miya, Darron Ikari is an individual health care provider with primary practice located at 159 W Hospitality Ln , San Bernardino CA 92408-3348. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Miya, Darron Ikari can be contacted via phone (909) 558-4616.Contact Information
Primary practice address
159 W Hospitality Ln
San Bernardino CA 92408-3348
Phone: (909) 558-4616
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 104627 | California |
Profile Details
| NPI number | 1114539442 |
|---|---|
| LBN Legal business name | Miya, Darron Ikari |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 18th, 2020 |
| Last updated | Sep 10th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114539442 | NPPES |
| California | Other | 104627 | CALIFORNIA DENTAL BOARD |
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