Provider Demographics
NPI:1053465591
Name:ROOS, ERIK H (DDS)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:H
Last Name:ROOS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2775 ESPLANADE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973
Mailing Address - Country:US
Mailing Address - Phone:530-893-4044
Mailing Address - Fax:530-893-4069
Practice Address - Street 1:2775 ESPLANADE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973
Practice Address - Country:US
Practice Address - Phone:530-893-4044
Practice Address - Fax:530-893-4069
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA457661223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA45766OtherDENTIST LICENSE