Healthcare Provider Details

I. General information

NPI: 1104278571
Provider Name (Legal Business Name): MARIA BEATRIZ RODRIGUEZ PEREZ D.D.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2016
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 SUTTER ST RM 2130
SAN FRANCISCO CA
94108-4112
US

IV. Provider business mailing address

450 SUTTER ST RM 2130
SAN FRANCISCO CA
94108-4112
US

V. Phone/Fax

Practice location:
  • Phone: 415-296-1126
  • Fax: 415-296-1128
Mailing address:
  • Phone: 415-296-1126
  • Fax: 415-296-1128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number100311
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: