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General NPI Number Information
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NPI Number | 1205058153
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Entity Type | Individual
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Provider Name | ROBERT JOSEPH DIMAYUGA D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 1436 CEDARWOOD LN STE A
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City | PLEASANTON
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State | CA
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Zip | 94566-6124
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Country | US
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Telephone | 925-484-2442
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Fax |
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Provider Business Mailing Address
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Address Line | 1436 CEDARWOOD LN STE A
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City | PLEASANTON
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State | CA
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Zip | 94566-6124
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Country | US
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Telephone | 925-463-3432
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 41601
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License Number State | CA
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