Provider Demographics
NPI:1619992492
Name:POPOVICI, RODICA T (DDS)
Entity Type:Individual
Prefix:
First Name:RODICA
Middle Name:T
Last Name:POPOVICI
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 1:4450 SAN PABLO DAM RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:EL SOBRANTE
Mailing Address - State:CA
Mailing Address - Zip Code:94803-3053
Mailing Address - Country:US
Mailing Address - Phone:510-222-1922
Mailing Address - Fax:510-222-2446
Practice Address - Street 1:4450 SAN PABLO DAM RD
Practice Address - Street 2:SUITE D
Practice Address - City:EL SOBRANTE
Practice Address - State:CA
Practice Address - Zip Code:94803-3053
Practice Address - Country:US
Practice Address - Phone:510-222-1922
Practice Address - Fax:510-222-2446
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA438461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
7459174OtherAETNA INSURANCE CO.
813885OtherUNITED CONCORDIA INSURANC