MEDICARE: RODEF DENTAL OFFICE OF CHINO HILLS INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry

General Provider Information

NPI Number	:	1548146111
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RODEF DENTAL OFFICE OF CHINO HILLS INC.

Provider Business Mailing Address
First Line	:	2235A E. GARVEY AVE N.
Second Line	:
City	:	WEST COVINA
State	:	CA
Zip	:	91791-1500
Country	:	US
Telephone Number	:	626-412-0200
Fax Number	:

Provider Business Practice Location Address
First Line	:	12171 CENTRAL AVE SUITE 11
Second Line	:
City	:	CHINO
State	:	CA
Zip	:	91710-2154
Country	:	US
Telephone Number	:	909-781-4453
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	FARIBORZ RODEF
Credential	:
Telephone Number	:	626-412-0200

Provider Enumeration Date	:	08/11/2025
Last Update Date	:	12/02/2025

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Directions to “RODEF DENTAL OFFICE OF CHINO HILLS INC. ” Practice Location

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