Provider Demographics
NPI:1790983948
Name:RODRIGUEZ, ARIEL JULIAN (DDS)
Entity Type:Individual
Prefix:
First Name:ARIEL
Middle Name:JULIAN
Last Name:RODRIGUEZ
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 1:428 ARDEN AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-1108
Mailing Address - Country:US
Mailing Address - Phone:818-243-4287
Mailing Address - Fax:818-243-2599
Practice Address - Street 1:428 ARDEN AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-1108
Practice Address - Country:US
Practice Address - Phone:818-243-4287
Practice Address - Fax:818-243-2599
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50179122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist