Basic Information
| Provider Information | |||||||||
| NPI: | 1457732513 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GHIBU | ||||||||
| FirstName: | ANA | ||||||||
| MiddleName: | |||||||||
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| Credential: | D.M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5005 STATE RD | ||||||||
| Address2: | |||||||||
| City: | ASHTABULA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440046265 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4409923146 | ||||||||
| FaxNumber: | 4409986932 | ||||||||
| Practice Location | |||||||||
| Address1: | 8162 E SANTA ANA CANYON RD STE 104 | ||||||||
| Address2: | |||||||||
| City: | ANAHEIM | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928081154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7142020765 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2015 | ||||||||
| LastUpdateDate: | 02/12/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/12/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 30-024521 | OH | N | Dental Providers | Dentist | General Practice | 1223G0001X | 103607 | CA | Y | Dental Providers | Dentist | General Practice |
No ID Information.