Healthcare Provider Details

I. General information

NPI: 1114892775
Provider Name (Legal Business Name): TELLES DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2025
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 N BELLFLOWER BLVD STE 301
LONG BEACH CA
90815-1145
US

IV. Provider business mailing address

2700 N BELLFLOWER BLVD STE 301
LONG BEACH CA
90815-1145
US

V. Phone/Fax

Practice location:
  • Phone: 562-421-8896
  • Fax: 562-429-4776
Mailing address:
  • Phone: 562-421-8896
  • Fax: 562-429-4776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. DAVID RODNEY TELLES
Title or Position: OWNER
Credential: DDS
Phone: 562-421-8896