Provider Demographics
NPI:1457904773
Name:RADU, ADRIAN (DDS)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:
Last Name:RADU
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 1:8211 SIERRA COLLEGE BLVD STE 404
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-9405
Mailing Address - Country:US
Mailing Address - Phone:916-771-0807
Mailing Address - Fax:916-771-0882
Practice Address - Street 1:8211 SIERRA COLLEGE BLVD STE 404
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-9405
Practice Address - Country:US
Practice Address - Phone:916-771-0807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-17
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1039491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice