Provider Demographics
NPI:1669601548
Name:WHEATLEY, RONALD SMITH (DDS)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:SMITH
Last Name:WHEATLEY
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 1:9900 MCFADDEN AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-6978
Mailing Address - Country:US
Mailing Address - Phone:714-531-5770
Mailing Address - Fax:714-531-1427
Practice Address - Street 1:46032 PASEO GALLANTE
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-1258
Practice Address - Country:US
Practice Address - Phone:951-302-6779
Practice Address - Fax:951-302-6946
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD18949122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist