Provider Demographics
NPI:1336250216
Name:FLEMING, DONALD ROBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:ROBERT
Last Name:FLEMING
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:DONALD
Other - Middle Name:R
Other - Last Name:FLEMING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS CORPORATION
Mailing Address - Street 1:7676 JACKSON DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92119-1500
Mailing Address - Country:US
Mailing Address - Phone:619-582-3600
Mailing Address - Fax:619-582-9406
Practice Address - Street 1:7676 JACKSON DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92119-1500
Practice Address - Country:US
Practice Address - Phone:619-582-3600
Practice Address - Fax:619-582-9406
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS 22215CA122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist