DR. MAURICIO RONDEROS DDS MS MPH NPI 1457402034

NPI Information

NPI: 1457402034
Provider Name: DR. MAURICIO RONDEROS, DDS, MS, MPH
Classification: Dentist - 1223P0300X
Entity Type: Individual

Specialization: Periodontics

PECOS Registration: Yes

Address:
358 MARINE PKWY STE 300
REDWOOD CITY, CA
ZIP 94065
Phone: (650) 595-5083
Get Directions

DR. Mauricio Ronderos, DDS, MS, MPH is a periodontics dentist in Redwood City, CA. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. DR. Mauricio Ronderos, DDS, MS, MPH NPI is 1457402034. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

358 MARINE PKWY STE 300
REDWOOD CITY, CA
ZIP 94065-211
Phone: (650) 595-5083
Fax: (650) 594-9236

The NPI 1457402034 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 1/12/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223P0300X	Dentist	Periodontics	47787	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	47787	OTHER	CALIFORNIA	DENTAL LINSENCE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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