Provider Demographics
NPI:1467059568
Name:RUPPERT-MAJER, MICAELA (DDS)
Entity Type:Individual
Prefix:
First Name:MICAELA
Middle Name:
Last Name:RUPPERT-MAJER
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 1:7 GRAY STONE WAY
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-9330
Mailing Address - Country:US
Mailing Address - Phone:949-573-3131
Mailing Address - Fax:
Practice Address - Street 1:270 E 17TH ST STE 15
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-3845
Practice Address - Country:US
Practice Address - Phone:714-224-2480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1054971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice