Provider Demographics
NPI:1063147197
Name:JULIO ORTEGA DDS INC
Entity type:Organization
Organization Name:JULIO ORTEGA DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:CRUZ
Authorized Official - Last Name:ORTEGA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-484-8081
Mailing Address - Street 1:9509 CENTRAL AVE STE D
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-2400
Mailing Address - Country:US
Mailing Address - Phone:562-484-8081
Mailing Address - Fax:
Practice Address - Street 1:9509 CENTRAL AVE STE D
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-2400
Practice Address - Country:US
Practice Address - Phone:562-484-8081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental