Healthcare Provider Details

I. General information

NPI: 1649184961
Provider Name (Legal Business Name): RACHELLE JOY DE EYOY MAGTANONG-MADRID DDS, PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10408 PARADISIO PL
SAN DIEGO CA
92127-2874
US

IV. Provider business mailing address

10408 PARADISIO PL
SAN DIEGO CA
92127-2874
US

V. Phone/Fax

Practice location:
  • Phone: 858-829-4176
  • Fax:
Mailing address:
  • Phone: 858-829-4176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. RACHELLE JOY DE EYOY MAGTANONG-MADRID
Title or Position: PRESIDENT
Credential: DDS
Phone: 858-829-4176