Healthcare Provider Details

I. General information

NPI: 1720114101
Provider Name (Legal Business Name): ROBERTO V ESPEJO JR DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

990 BAY STREET
MOUNTAIN VIEW CA
94040
US

IV. Provider business mailing address

990 BAY STREET
MOUNTAIN VIEW CA
94040
US

V. Phone/Fax

Practice location:
  • Phone: 650-968-4000
  • Fax: 650-691-4472
Mailing address:
  • Phone: 650-968-4000
  • Fax: 650-691-4472

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: DR. ROBERTO V ESPEJO JR.
Title or Position: PRESIDENT
Credential: DDS
Phone: 650-968-4000