Provider Demographics
NPI:1649423088
Name:DREXLER, JEAN CECILIA (DDS RPH)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:CECILIA
Last Name:DREXLER
Suffix:
Gender:F
Credentials:DDS RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20351 WIND CAVE LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-5342
Mailing Address - Country:US
Mailing Address - Phone:714-968-0138
Mailing Address - Fax:
Practice Address - Street 1:940 N TUSTIN ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-5956
Practice Address - Country:US
Practice Address - Phone:714-633-1681
Practice Address - Fax:714-244-1200
Is Sole Proprietor?:No
Enumeration Date:2008-10-29
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43762183500000X
CA371021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No183500000XPharmacy Service ProvidersPharmacist