Ivan Noel Casillas Rodriguez
Dentist, General Practice in Nuevo, CA. Individual provider (NPI-1).
NPI number1245136100
StatusActive
Last updated in NPPESOct 16, 2026
Details
- NPI
- 1245136100
- Entity type
- Individual (NPI-1)
- Name
- Ivan Noel Casillas Rodriguez
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 16, 2026
- Certification date
- Oct 16, 2026
- Last updated
- Oct 16, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 113613 | CA | Yes |
Practice location
29616 Nuevo RdNuevo, CA 92567-9201
Phone 951-928-4333
Mailing address
29616 Nuevo RdNuevo, CA 92567-9201
Phone 951-928-4333
Other practice locations
6348 Mission Blvd
Jurupa Valley, CA 92509-4115
Jurupa Valley, CA 92509-4115
Phone 951-592-3453
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