Healthcare Provider Details

I. General information

NPI: 1598464026
Provider Name (Legal Business Name): RODEF DENTAL OFFICE OF OXNARD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2023
Last Update Date: 02/23/2023
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2085 N. OXNARD BLVD
OXNARD CA
93036-2964
US

IV. Provider business mailing address

2235A E. GARVEY AVE N.
WEST COVINA CA
91791-1540
US

V. Phone/Fax

Practice location:
  • Phone: 626-412-0200
  • Fax:
Mailing address:
  • Phone: 626-412-0200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: FARIBORZ RODEF
Title or Position: CEO/PRESIDENT
Credential:
Phone: 626-412-0200