Provider Demographics
NPI:1972661007
Name:MAEDA, RONALD A (DDS INC)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:A
Last Name:MAEDA
Suffix:
Gender:M
Credentials:DDS INC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9872 CHAPMAN AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92841-2733
Mailing Address - Country:US
Mailing Address - Phone:714-638-5630
Mailing Address - Fax:714-638-5632
Practice Address - Street 1:9872 CHAPMAN AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92841-2733
Practice Address - Country:US
Practice Address - Phone:714-638-5630
Practice Address - Fax:714-638-5632
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19358122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist