Provider Demographics
NPI:1386864924
Name:JECMEN, ROBERT (DDS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:JECMEN
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 1:8221 3RD ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-3717
Mailing Address - Country:US
Mailing Address - Phone:562-923-5496
Mailing Address - Fax:562-923-0658
Practice Address - Street 1:8221 3RD ST
Practice Address - Street 2:SUITE 310
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-3717
Practice Address - Country:US
Practice Address - Phone:562-923-5496
Practice Address - Fax:562-923-0658
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA283341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice