Provider Demographics
NPI:1215013172
Name:RODERICK F. LAGUNDA DDS
Entity type:Organization
Organization Name:RODERICK F. LAGUNDA DDS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RODERICK
Authorized Official - Middle Name:FERRER
Authorized Official - Last Name:LAGUNDA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-450-0888
Mailing Address - Street 1:6648 IRVINE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2117
Mailing Address - Country:US
Mailing Address - Phone:949-450-0888
Mailing Address - Fax:949-861-7018
Practice Address - Street 1:6648 IRVINE CENTER DR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-2117
Practice Address - Country:US
Practice Address - Phone:949-450-0888
Practice Address - Fax:949-861-7018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA440011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty