GENELLE MORALES CUSTODIA (NPI# 1568732725) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568732725 |
| Entity Type | Individual |
| Full Name | GENELLE MORALES CUSTODIA |
| Credential | RDH |
| Practice Address |
10602 Chapman Ave Ste 200 Garden Grove CA 92840-3147 |
| Mailing Address |
26969 Orchid Ave Mission Viejo CA 92692-4135 |
| Practice Telephone | 7146387637 |
| Mailing Telephone | 7149883164 |
| Enumeration Date | 2012-01-05 |
| Last Update Date | 2012-01-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | 26412 | CA | Dental Providers |
| Street Address |
10602 CHAPMAN AVE STE 200 |
| City | GARDEN GROVE |
| State | CA |
| Zip Code | 92840-3147 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326103474 | Christina Maldonado | Dentist | 10602 Chapman Ave Ste 200, Garden Grove, CA 92840-3147 | 2006-12-27 |
| 1003389198 | Neelam Patel | Dental Hygienist | 10602 Chapman Ave Ste 200, Garden Grove, CA 92840-3147 | 2019-01-10 |
| 1477029635 | Nadia Berenice Gutierrez | Dental Hygienist | 10602 Chapman Ave Ste 200, Garden Grove, CA 92840-3147 | 2018-10-15 |
| 1457837940 | Catherine My-hanh Pham | Dentist | 10602 Chapman Ave Ste 200, Garden Grove, CA 92840-3147 | 2018-07-17 |
| 1962993824 | Gary Gang Liu | Dentist | 10602 Chapman Ave Ste 200, Garden Grove, CA 92840-3147 | 2018-05-25 |
| 1003303140 | Li Hong Huang | Dentist | 10602 Chapman Ave Ste 200, Garden Grove, CA 92840-3147 | 2018-04-14 |
| 1982118469 | Jenny H Kim | Dental Hygienist | 10602 Chapman Ave Ste 200, Garden Grove, CA 92840-3147 | 2017-11-20 |
| 1255842720 | Shawn Elizabeth Wild | Dental Hygienist | 10602 Chapman Ave Ste 200, Garden Grove, CA 92840-3147 | 2017-10-23 |
| 1508377722 | Karina Rivas | Dental Hygienist | 10602 Chapman Ave Ste 200, Garden Grove, CA 92840-3147 | 2017-10-15 |
| 1275051351 | Elizabeth Frances Doherty | Dental Hygienist | 10602 Chapman Ave Ste 200, Garden Grove, CA 92840-3147 | 2017-09-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588283808 | Kimberly Gaeta | Behavioral Analyst | 123935 Lewis Street, Ste 202, Garden Grove, CA 92840 | 2020-04-16 |
| 1396397170 | Rosa Cortez | Behavior Technician | 12443 Lewis Street, #201, Garden Grove, CA 92840 | 2019-07-12 |
| 1376005934 | Sekboppa Sor | Nurse Practitioner | An Lanh Free Clinic, 10861 Acacia Pkwy., Garden Grove, CA 92840 | 2019-04-03 |
| 1346730116 | Vinh Le Tran | Pharmacist | 12666 Brookhurst St. Suite 110, Garden Grove, CA 92840 | 2018-05-16 |
| 1841715232 | Scott R. Blair | Physician Assistant | 12828 Harbor Blvd Ste 200, Garden Grove, CA 92840 | 2017-08-07 |
| 1881049492 | Carmen Keally | Dietitian, Registered | 12602 9th St, Garden Grove, CA 92840 | 2016-05-02 |
| 1548688732 | House Call Medical Associates, Inc. | Internal Medicine | 12865 Main St Ste 105, Garden Grove, CA 92840 | 2014-04-03 |
| 1851733059 | Carly Ann Wade | Marriage & Family Therapist | 12755 Brookhurst St. Ste 116, Garden Grove, CA 92840 | 2013-07-29 |
| 1003159864 | Priyal Shah Ohri | Dentist | 10602 Chapman Ave, Suite 200, Garden Grove, CA 92840 | 2013-03-30 |
| 1770853244 | Joseph Pham | Pharmacist | 12001 Euclid St., Garden Grove, CA 92840 | 2011-12-30 |
| Find all providers in zip 92840 | ||||
| Taxonomy Code | 124Q00000X |
| Grouping | Dental Providers |
| Classification | Dental Hygienist |
| An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033678487 | Quoc-hiep Phan Dao | Dental Hygienist | 13691 Cypress St, Garden Grove, CA 92843-3230 | 2019-03-15 |
| 1932608536 | Nardeen Anwar | Dental Hygienist | 13171 Balboa Ave Apt 1, Garden Grove, CA 92840-4450 | 2018-02-08 |
| 1073065058 | Jennifer Lee | Dental Hygienist | 8832 Dakota Ave, Garden Grove, CA 92844-2016 | 2016-10-26 |
| 1407225907 | Florie Vanessa Mancilla | Dental Hygienist | 10602 Chapman Ave #200, Garden Grove, CA 92840-4700 | 2015-09-15 |
| 1134557978 | Paula Phuong Nguyen | Dental Hygienist | 9002 Marylee Dr, Garden Grove, CA 92841-2405 | 2013-10-14 |
| 1487933701 | Ann H Bui | Dental Hygienist | 9877 Chapman Ave., Ste. D #140, Garden Grove, CA 92841 | 2011-08-04 |
| 1891081089 | Kimberly Lynn Cruz | Dental Hygienist | 12562 Dale St Unit 30, Garden Grove, CA 92841-4565 | 2011-06-26 |
| 1912144643 | Linh T Ho | Dental Hygienist | 10461 Hazard Ave, Garden Grove, CA 92843-5104 | 2009-01-16 |
| 1003389198 | Neelam Patel | Dental Hygienist | 10602 Chapman Ave Ste 200, Garden Grove, CA 92840-3147 | 2019-01-10 |
| 1477029635 | Nadia Berenice Gutierrez | Dental Hygienist | 10602 Chapman Ave Ste 200, Garden Grove, CA 92840-3147 | 2018-10-15 |
| Find all providers in GARDEN GROVE | ||||
| City | GARDEN GROVE |
| Zip Code | 92840 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.