Provider Demographics
NPI:1407185184
Name:DIXON, ROSS H (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:H
Last Name:DIXON
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 1:5627 OBERLIN DR
Mailing Address - Street 2:SUITE #100
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-3748
Mailing Address - Country:US
Mailing Address - Phone:858-452-4298
Mailing Address - Fax:858-452-0710
Practice Address - Street 1:5627 OBERLIN DR
Practice Address - Street 2:SUITE #100
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-3748
Practice Address - Country:US
Practice Address - Phone:858-452-4298
Practice Address - Fax:858-452-0710
Is Sole Proprietor?:No
Enumeration Date:2009-12-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA477151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice