Provider Demographics
NPI:1487702114
Name:CEJA, FRANK L (DDS)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:L
Last Name:CEJA
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 1:3007 HIGHLAND AVE
Mailing Address - Street 2:STE 3
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-7451
Mailing Address - Country:US
Mailing Address - Phone:619-477-2189
Mailing Address - Fax:619-477-3400
Practice Address - Street 1:3007 HIGHLAND AVE
Practice Address - Street 2:STE 3
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-7451
Practice Address - Country:US
Practice Address - Phone:619-477-2189
Practice Address - Fax:619-477-3400
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA412361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB4123601Medicaid