Provider Demographics
NPI:1790906329
Name:IONESCU, HORIA THEODOR (DDS)
Entity Type:Individual
Prefix:DR
First Name:HORIA
Middle Name:THEODOR
Last Name:IONESCU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9381 E STOCKTON BLVD
Mailing Address - Street 2:SUITE # 100
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-5068
Mailing Address - Country:US
Mailing Address - Phone:916-685-4662
Mailing Address - Fax:
Practice Address - Street 1:9381 E STOCKTON BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-5068
Practice Address - Country:US
Practice Address - Phone:916-685-4662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA471001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice