Healthcare Provider Details

I. General information

NPI: 1255268181
Provider Name (Legal Business Name): GERIMAE NAVOA DEL ROSARIO DENTIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17808 PIONEER BLVD STE 110
ARTESIA CA
90701-4422
US

IV. Provider business mailing address

17808 PIONEER BLVD STE 110
ARTESIA CA
90701-4422
US

V. Phone/Fax

Practice location:
  • Phone: 714-812-5487
  • Fax:
Mailing address:
  • Phone: 714-812-5487
  • Fax: 562-809-0500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number110634
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: