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Provider Information for 1881809093

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. NAVEEN VATTEPU SAMUEL DDS

Gender: MALE

Individual NPI: 1881809093

Calendar   Last Updated:  2007-07-08
  Certification Date: 

Details

Name Value
NPI 1881809093
Enumeration Date 2007-05-11
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 6860 BROCKTON AVE SUITE 10
RIVERSIDE, CA 92506-3816
United States

Phone: 951-683-5225 | Fax: 951-346-5570
View Map External Link
Primary Practice Address 6860 BROCKTON AVE SUITE 10
RIVERSIDE, CA 92506-3816
United States

Phone: 951-683-5225 | Fax: 951-346-5570
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist CA 51299