Healthcare Provider Details

I. General information

NPI: 1467470401
Provider Name (Legal Business Name): ROBERT CHARLES CURRERI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24953 PASEO DE VALENCIA SUITE #1C
LAGUNA HILLS CA
92653
US

IV. Provider business mailing address

24953 PASEO DE VALENCIA SUITE #1C
LAGUNA HILLS CA
92653
US

V. Phone/Fax

Practice location:
  • Phone: 949-768-4071
  • Fax: 949-768-0292
Mailing address:
  • Phone: 949-768-4071
  • Fax: 949-768-0292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number20064
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: