Provider Demographics
NPI:1619206075
Name:RUMMLER, KEVIN D (DDS)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:D
Last Name:RUMMLER
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 1:5185 BALL RD STE B
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-3666
Mailing Address - Country:US
Mailing Address - Phone:714-827-0500
Mailing Address - Fax:
Practice Address - Street 1:5185 BALL RD STE B
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-3666
Practice Address - Country:US
Practice Address - Phone:714-827-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-15
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA384581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice