Provider Demographics
NPI:1225231996
Name:ESCUDERO, RYAN DANIEL (DMD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:DANIEL
Last Name:ESCUDERO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3532 HOWARD AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3681
Mailing Address - Country:US
Mailing Address - Phone:562-795-7777
Mailing Address - Fax:
Practice Address - Street 1:3532 HOWARD AVE STE 100
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3681
Practice Address - Country:US
Practice Address - Phone:562-795-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY05244111223G0001X
MA222761223G0001X
CA592561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice