Provider Demographics
NPI:1306388368
Name:REXIE M OLIVERIA,DDS INC.
Entity Type:Organization
Organization Name:REXIE M OLIVERIA,DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RESURRECCION
Authorized Official - Middle Name:MEDINA
Authorized Official - Last Name:OLIVERIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-479-1771
Mailing Address - Street 1:2220 E PLAZA BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-5162
Mailing Address - Country:US
Mailing Address - Phone:619-479-1771
Mailing Address - Fax:619-479-1135
Practice Address - Street 1:2220 E PLAZA BLVD STE B
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-5162
Practice Address - Country:US
Practice Address - Phone:619-479-1771
Practice Address - Fax:619-479-1135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-08
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty