Provider Demographics
NPI:1992358964
Name:NIEBLAS, ROBLEN GUEVARRA (DDS)
Entity Type:Individual
Prefix:
First Name:ROBLEN
Middle Name:GUEVARRA
Last Name:NIEBLAS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ROBLEN
Other - Middle Name:PANGILINAN
Other - Last Name:GUEVARRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:PO BOX 580
Mailing Address - Street 2:
Mailing Address - City:LEMOORE
Mailing Address - State:CA
Mailing Address - Zip Code:93245-0580
Mailing Address - Country:US
Mailing Address - Phone:559-386-4500
Mailing Address - Fax:559-386-5080
Practice Address - Street 1:3554 W MT WHITNEY
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:CA
Practice Address - Zip Code:93656
Practice Address - Country:US
Practice Address - Phone:559-867-4000
Practice Address - Fax:559-867-1100
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-18
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1040581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice