Provider Demographics
NPI:1881860120
Name:ROSS, RHODA S (DDS)
Entity type:Individual
Prefix:DR
First Name:RHODA
Middle Name:S
Last Name:ROSS
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 1:1711 VIA EL PRADO
Mailing Address - Street 2:STE 303
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-5714
Mailing Address - Country:US
Mailing Address - Phone:310-792-4833
Mailing Address - Fax:
Practice Address - Street 1:1711 VIA EL PRADO
Practice Address - Street 2:STE 303
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-5714
Practice Address - Country:US
Practice Address - Phone:310-792-4833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADG333611223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics