Healthcare Provider Details

I. General information

NPI: 1558572859
Provider Name (Legal Business Name): ROBERTO V ESPEJO JR. DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 03/14/2022
Certification Date: 08/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

990 BAY ST
MOUNTAIN VIEW CA
94040-2681
US

IV. Provider business mailing address

3278 NOBLE AVE
SAN JOSE CA
95132-3129
US

V. Phone/Fax

Practice location:
  • Phone: 659-698-4000
  • Fax:
Mailing address:
  • Phone: 408-937-8333
  • Fax: 408-923-4457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number37820
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: