Healthcare Provider Details

I. General information

NPI: 1326043662
Provider Name (Legal Business Name): ROGER RAMIREZ CEDILLO D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 09/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8036 PAINTER AVE
WHITTIER CA
90602-2507
US

IV. Provider business mailing address

8036 PAINTER AVE
WHITTIER CA
90602-2507
US

V. Phone/Fax

Practice location:
  • Phone: 562-907-2645
  • Fax:
Mailing address:
  • Phone: 562-907-2645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number42285
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: