Provider Demographics
NPI:1912197302
Name:BURTON, RODNEY PAUL (DDS)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:PAUL
Last Name:BURTON
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 1:228 LOMBARD ST STE C
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-8202
Mailing Address - Country:US
Mailing Address - Phone:805-494-1500
Mailing Address - Fax:805-435-1809
Practice Address - Street 1:228 LOMBARD ST STE C
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-8202
Practice Address - Country:US
Practice Address - Phone:805-494-1500
Practice Address - Fax:805-435-1809
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33554122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist