Provider Demographics
NPI:1740445493
Name:CILDERMAN, MATTHEW (DDS)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:CILDERMAN
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 1:4848 LAKEVIEW AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-3453
Mailing Address - Country:US
Mailing Address - Phone:714-695-9992
Mailing Address - Fax:714-695-9994
Practice Address - Street 1:4848 LAKEVIEW AVE STE 102
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-3453
Practice Address - Country:US
Practice Address - Phone:714-695-9992
Practice Address - Fax:714-695-9994
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-22
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57152122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist