Provider Demographics
NPI:1831418003
Name:FUNADA, DEAN (DDS)
Entity type:Individual
Prefix:
First Name:DEAN
Middle Name:
Last Name:FUNADA
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 1:897 EMBARCADERO DR
Mailing Address - Street 2:SUITE 211
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-4097
Mailing Address - Country:US
Mailing Address - Phone:916-933-5100
Mailing Address - Fax:916-933-5187
Practice Address - Street 1:897 EMBARCADERO DR
Practice Address - Street 2:SUITE 211
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-4097
Practice Address - Country:US
Practice Address - Phone:916-933-5100
Practice Address - Fax:916-933-5187
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43960122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist