=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114870573
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RODEF DENTAL OFFICE OF CORONA INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/17/2026
-----------------------------------------------------
Last Update Date | 02/17/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 341 SOUTH LINCOLN AVENUE SUITE D
-----------------------------------------------------
City | CORONA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92882
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-268-2331
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2235A E. GARVEY AVE N
-----------------------------------------------------
City | WEST COVINA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91791-1500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-412-0200
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | FARIBORZ RODEF
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 626-412-0200
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223P0221X
-----------------------------------------------------
Taxonomy Name | Pediatric Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------