Provider Demographics
NPI:1376750067
Name:NOBLE-DURIAN, ROCHELI BULANADI (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROCHELI
Middle Name:BULANADI
Last Name:NOBLE-DURIAN
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 1:18800 AMAR RD
Mailing Address - Street 2:SUITE #C4
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-4166
Mailing Address - Country:US
Mailing Address - Phone:626-581-0069
Mailing Address - Fax:626-581-0070
Practice Address - Street 1:18800 AMAR RD
Practice Address - Street 2:SUITE #C4
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91789-4166
Practice Address - Country:US
Practice Address - Phone:626-581-0069
Practice Address - Fax:626-581-0070
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA493811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice