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General NPI Number Information
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NPI Number | 1982591186
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Entity Type | Organization
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Legal Business Name | RODEF DENTAL OFFICE OF MORENO VALLEY, INC
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Dates
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Enumeration Date | 06/20/2025
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 12640 DAY STREET
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City | MORENO VALLEY
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State | CA
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Zip | 92553
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Country | US
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Telephone | 951-732-8966
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Fax |
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Provider Business Mailing Address
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Address Line | 2235A E.GARVEY AVE N.
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City | WEST COVINA
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State | CA
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Zip | 91791-1500
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Country | US
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Telephone | 626-412-0200
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | FARIBORZ RODEF
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Credential | DDS
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Telephone | 626-412-0200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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