MEDICARE: RODICA T. POPOVICI DDS

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	1223G0001X	General Practice Dentistry	43846	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7459174	OTHER		AETNA INSURANCE CO.
2	813885	OTHER		UNITED CONCORDIA INSURANC

General Provider Information

NPI Number	:	1619992492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RODICA T. POPOVICI DDS

Provider Business Mailing Address
First Line	:	4450 SAN PABLO DAM RD
Second Line	:	SUITE D
City	:	EL SOBRANTE
State	:	CA
Zip	:	94803-3053
Country	:	US
Telephone Number	:	510-222-1922
Fax Number	:	510-222-2446

Provider Business Practice Location Address
First Line	:	4450 SAN PABLO DAM RD
Second Line	:	SUITE D
City	:	EL SOBRANTE
State	:	CA
Zip	:	94803-3053
Country	:	US
Telephone Number	:	510-222-1922
Fax Number	:	510-222-2446

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	02/13/2014

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