Ronald Mavin Georgeson, DDS
Individual provider Active NPI Endodontics · Kerman, CA
NPI 1295850006 · NPPES record last updated Aug 24, 2022
Key facts
- NPI
- 1295850006
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Endodontics 1223E0200X
- License
- 033090 (CA)
- Practice address
- 14941 W Whitesbridge Ave
Kerman, CA 93630-1111 - Phone
- (559) 846-6624
- Fax
- (559) 272-5067
- NPI assigned
- Mar 20, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 033090 | CA | MD | Endodontist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 033090 | CA | Yes |
Addresses
Primary practice location
14941 W Whitesbridge Ave
Kerman, CA 93630-1111
Mailing address
14941 W Whitesbridge Ave
Kerman, CA 93630-1111
Phone (559) 846-6624
Other providers in Kerman, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.