Provider Demographics
NPI:1699146886
Name:NEGRETE, RIGOBERTO (DDS)
Entity type:Individual
Prefix:DR
First Name:RIGOBERTO
Middle Name:
Last Name:NEGRETE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11230 SORRENTO VALLEY RD
Mailing Address - Street 2:STE 130
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-1332
Mailing Address - Country:US
Mailing Address - Phone:858-391-6738
Mailing Address - Fax:
Practice Address - Street 1:11230 SORRENTO VALLEY RD
Practice Address - Street 2:STE 130
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1332
Practice Address - Country:US
Practice Address - Phone:858-391-6738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-13
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65142122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist