Healthcare Provider Details

I. General information

NPI: 1124975214
Provider Name (Legal Business Name): HECTOR EDUARDO CORDERO LOPEZ DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DR. HECTOR CORDERO

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2765 NEWCASTLE WAY
SAN JACINTO CA
92582-3749
US

IV. Provider business mailing address

2765 NEWCASTLE WAY
SAN JACINTO CA
92582-3749
US

V. Phone/Fax

Practice location:
  • Phone: 951-435-9964
  • Fax:
Mailing address:
  • Phone: 951-435-9964
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number112789
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: