Individual
KANISHA GOLDSMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
5162 WHITTIER BLVD, LOS ANGELES, CA 90022-3932
(323) 415-6161
Mailing address
5162 WHITTIER BLVD, LOS ANGELES, CA 90022-3932
(323) 415-6161
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
72132
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
72132
—
CA
Enumeration date
03/15/2017
Last updated
03/15/2017
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