Healthcare Provider Details

I. General information

NPI: 1619423027
Provider Name (Legal Business Name): DANA ROBERTS-RIEGER DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2016
Last Update Date: 08/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26700 TOWNE CENTRE DR SUITE 240
FOOTHILL RANCH CA
92610-2844
US

IV. Provider business mailing address

26700 TOWNE CENTRE DR SUITE 240
FOOTHILL RANCH CA
92610-2844
US

V. Phone/Fax

Practice location:
  • Phone: 949-581-5151
  • Fax: 949-581-6058
Mailing address:
  • Phone: 949-581-5151
  • Fax: 949-581-6058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number46424
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: