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General NPI Number Information
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NPI Number | 1144803313
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Entity Type | Individual
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Provider Name | ROSEMARIE ATHENA TEIXEIRA
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Gender | Female
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Dates
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Enumeration Date | 05/04/2021
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 3400 CALIFORNIA ST STE 200
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-1863
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Country | US
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Telephone | 415-567-2408
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Fax |
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Provider Business Mailing Address
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Address Line | 121 N 2ND ST APT 311
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City | PHILADELPHIA
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State | PA
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Zip | 19106-2015
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Country | US
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Telephone | 781-591-9668
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 108019
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS044384
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License Number State | PA
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