Provider Demographics
NPI:1144555806
Name:ENDRIZZI VECCI, JULIA L (DMD)
Entity type:Individual
Prefix:DR
First Name:JULIA
Middle Name:L
Last Name:ENDRIZZI VECCI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 W GONZALES RD STE 300
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-9003
Mailing Address - Country:US
Mailing Address - Phone:805-983-0100
Mailing Address - Fax:
Practice Address - Street 1:451 W GONZALES RD STE 300
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-9003
Practice Address - Country:US
Practice Address - Phone:805-983-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-13
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ024803122300000X
PADS038099122300000X
CAD609511223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ22DI02480300OtherNEW JERSEY BOARD OF DENTISTRY
PADS03899OtherSTATE LICENSE NUMBER
CAD60951OtherDENTAL LICENSE CALIFORNIA