Healthcare Provider Details

I. General information

NPI: 1972706224
Provider Name (Legal Business Name): RODNEY HEATH KLEIGER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

959 EAST WALNUT ST SUITE 216
PASADENA CA
91106-5360
US

IV. Provider business mailing address

959 EAST WALNUT ST SUITE 216
PASADENA CA
91106-5360
US

V. Phone/Fax

Practice location:
  • Phone: 626-793-6175
  • Fax: 626-793-9317
Mailing address:
  • Phone: 626-793-6175
  • Fax: 626-793-9317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number47922
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: