Provider Demographics
NPI:1053334136
Name:ROJAS, EDITH (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDITH
Middle Name:
Last Name:ROJAS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6120 S STAPLES ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-2904
Mailing Address - Country:US
Mailing Address - Phone:361-299-5950
Mailing Address - Fax:361-356-6287
Practice Address - Street 1:6120 S STAPLES ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-2904
Practice Address - Country:US
Practice Address - Phone:361-299-5950
Practice Address - Fax:361-356-6287
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX210381223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1590374-02Medicaid