Provider Demographics
NPI:1013697085
Name:FERNANDO CABALLERO, DDS AND ISABEL PEREZ DDS. PS
Entity Type:Organization
Organization Name:FERNANDO CABALLERO, DDS AND ISABEL PEREZ DDS. PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JADGEV
Authorized Official - Middle Name:
Authorized Official - Last Name:HEIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-441-5483
Mailing Address - Street 1:4170 TRUXEL ROAD
Mailing Address - Street 2:SUITE C
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11511 NE 195TH ST
Practice Address - Street 2:#104
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011
Practice Address - Country:US
Practice Address - Phone:425-481-5302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty