MEDICARE: DR. JEANETTE ROJAS ESTIPONA D.D.S.

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	122300000X	Dentist	50459	CA

General Provider Information

NPI Number	:	1750328696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEANETTE ROJAS ESTIPONA D.D.S.

Provider Business Mailing Address
First Line	:	2601 DUHALLOW WAY
Second Line	:
City	:	SOUTH SAN FRANCISCO
State	:	CA
Zip	:	94080-3826
Country	:	US
Telephone Number	:	650-296-6952
Fax Number	:

Provider Business Practice Location Address
First Line	:	1133 EL CAMINO REAL
Second Line	:
City	:	SOUTH SAN FRANCISCO
State	:	CA
Zip	:	94080-3288
Country	:	US
Telephone Number	:	650-296-6952
Fax Number	:

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

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	07/08/2007

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