Provider Demographics
NPI:1376066407
Name:ORTEGA, REBECCA LEE (DDS)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:LEE
Last Name:ORTEGA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1829 JEFFREY AVE
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92027-4440
Mailing Address - Country:US
Mailing Address - Phone:619-278-8030
Mailing Address - Fax:
Practice Address - Street 1:9331 MISSION GORGE RD STE 105
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-3883
Practice Address - Country:US
Practice Address - Phone:619-448-2158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-20
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101558122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist