Healthcare Provider Details

I. General information

NPI: 1689515173
Provider Name (Legal Business Name): ROSENBERG DELGADO RDH AP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1285 E SUNSET DR
CASA GRANDE AZ
85122-2942
US

IV. Provider business mailing address

PO BOX 11639
CASA GRANDE AZ
85130
US

V. Phone/Fax

Practice location:
  • Phone: 806-292-9115
  • Fax:
Mailing address:
  • Phone: 806-292-9115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberH009188
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: