MEDICARE: DR. RYAN DANIEL ESCUDERO D.M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	0524411	NY
2	1223G0001X	General Practice Dentistry	22276	MA
3	1223G0001X	General Practice Dentistry	59256	CA

General Provider Information

NPI Number	:	1225231996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RYAN DANIEL ESCUDERO D.M.D

Provider Business Mailing Address
First Line	:	3532 HOWARD AVE STE 100
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-3681
Country	:	US
Telephone Number	:	562-795-7777
Fax Number	:

Provider Business Practice Location Address
First Line	:	3532 HOWARD AVE STE 100
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-3681
Country	:	US
Telephone Number	:	562-795-7777
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2007
Last Update Date	:	02/07/2025

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