NPIMap

Organization Active NPI

Rodef & Moadel Dental Corp

  • Pediatric Dentistry
  • Montebello, CA
National Provider Identifier
1114158151
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
38356 Issued in CA
Legal business name
RODEF & MOADEL DENTAL CORP
Practice address
137 N Monebello Blvd
#H
Montebello, CA 90640-0000
Phone
(310) 625-3773
Fax
(626) 966-3063
NPI assigned
Aug 6, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Fariborz Rodef, DDSNPI 1548357262
Title
President Ceo
Phone
(626) 412-0200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 38356 CA Primary

Addresses

Primary practice location

137 N Monebello Blvd
#H
Montebello, CA 90640-0000

Mailing address

137 N Monebello Blvd
#H
Montebello, CA 90640-0000
Phone (310) 625-3773

Other names 1

  • childrens dental funzone Doing business as

National Provider Directory

National Provider Directory

Locations

137 N Montebello Blvd
Ste H
Montebello, CA 90640
Phone (310) 625-3773

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671580800000",
    "number": "1114158151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 N MONEBELLO BLVD",
            "address_2": "#H",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906400000",
            "telephone_number": "310-625-3773",
            "fax_number": "626-966-3063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 N MONEBELLO BLVD",
            "address_2": "#H",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906400000",
            "telephone_number": "310-625-3773",
            "fax_number": "626-966-3063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RODEF & MOADEL DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-06",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A",
        "authorized_official_last_name": "RODEF",
        "authorized_official_first_name": "FARIBORZ",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "626-412-0200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "38356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "childrens dental funzone",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montebello, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.