Provider Demographics
NPI:1477793255
Name:ROSS-ARAUJO, CELSO LEITE (DDS)
Entity Type:Individual
Prefix:
First Name:CELSO
Middle Name:LEITE
Last Name:ROSS-ARAUJO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:ROSS
Other - Middle Name:
Other - Last Name:ARAUJO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:77 ROLLING OAKS DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91361-1011
Mailing Address - Country:US
Mailing Address - Phone:805-496-0660
Mailing Address - Fax:
Practice Address - Street 1:77 ROLLING OAKS DR
Practice Address - Street 2:SUITE 104
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-1011
Practice Address - Country:US
Practice Address - Phone:805-496-0660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-06
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47036122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist