Healthcare Provider Details

I. General information

NPI: 1992513691
Provider Name (Legal Business Name): VERONICA MONTEMAGNI RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VERONICA MONTEMAGNI RDH, RDA

II. Dates (important events)

Enumeration Date: 12/27/2024
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4371 LATHAM ST
RIVERSIDE CA
92501-1706
US

IV. Provider business mailing address

7154 TRINITY ST
FONTANA CA
92336-2924
US

V. Phone/Fax

Practice location:
  • Phone: 833-867-4642
  • Fax:
Mailing address:
  • Phone: 909-215-6727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberRDH23035
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: