Provider Demographics
NPI:1386436863
Name:ROXAS, MARIA REGINA TRINIDA CAMARA (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:MARIA REGINA TRINIDA
Middle Name:CAMARA
Last Name:ROXAS
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5700 HIGHLANDS PLAZA DR APT 5051
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1381
Mailing Address - Country:US
Mailing Address - Phone:630-746-9122
Mailing Address - Fax:
Practice Address - Street 1:883 SNEATH LN # 130
Practice Address - Street 2:
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-2409
Practice Address - Country:US
Practice Address - Phone:650-589-4563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1110221223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty