Provider Demographics
NPI:1598251456
Name:WINTER, JULIA A (RDH COM)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:A
Last Name:WINTER
Suffix:
Gender:F
Credentials:RDH COM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 PALISADES DR APT 321
Mailing Address - Street 2:
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-2848
Mailing Address - Country:US
Mailing Address - Phone:310-968-4070
Mailing Address - Fax:
Practice Address - Street 1:501 PALISADES DR APT 321
Practice Address - Street 2:
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272-2848
Practice Address - Country:US
Practice Address - Phone:310-968-4070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA4041124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty