Provider Demographics
NPI:1811498991
Name:BEJASA, RIZZA AURICA MINDANAO (DDS)
Entity type:Individual
Prefix:DR
First Name:RIZZA AURICA
Middle Name:MINDANAO
Last Name:BEJASA
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 1:1649 N LIMA ST
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-1854
Mailing Address - Country:US
Mailing Address - Phone:818-535-0071
Mailing Address - Fax:
Practice Address - Street 1:310 S LAKE AVE STE B1
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-3540
Practice Address - Country:US
Practice Address - Phone:626-669-3141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-23
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1061371223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry