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General NPI Number Information
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NPI Number | 1588854152
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Entity Type | Individual
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Provider Name | RYAN CURTIS PENDLETON D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/30/2007
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Last Update Date | 03/13/2018
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Provider Practice Location Address
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Address Line | 18433 ROSCOE BLVD SUITE #201
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City | NORTHRIDGE
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State | CA
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Zip | 91325-4108
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Country | US
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Telephone | 818-882-0100
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Fax | 818-882-0101
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Provider Business Mailing Address
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Address Line | 1840 CRYSTAL FALLS PARKWAY SUITE #420
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City | LEANDER
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State | TX
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Zip | 78641-4108
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Country | US
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Telephone | 512-355-7727
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Fax | 512-355-7729
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 31552
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License Number State | TX
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