Provider Demographics
NPI:1649487273
Name:RODERICK HEMPT & RALPH STANLEY, DDS, INC.
Entity type:Organization
Organization Name:RODERICK HEMPT & RALPH STANLEY, DDS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:H
Authorized Official - Last Name:STANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-267-2550
Mailing Address - Street 1:1660 HILLSDALE AVE
Mailing Address - Street 2:130
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-3242
Mailing Address - Country:US
Mailing Address - Phone:408-267-2550
Mailing Address - Fax:408-267-1411
Practice Address - Street 1:1660 HILLSDALE AVE
Practice Address - Street 2:130
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-3242
Practice Address - Country:US
Practice Address - Phone:408-267-2550
Practice Address - Fax:408-267-1411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA309651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty