Healthcare Provider Details

I. General information

NPI: 1104753391
Provider Name (Legal Business Name): JANETTE DUNIVAN DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 DE SOUZA PL
BAKERSFIELD CA
93309-5100
US

IV. Provider business mailing address

12609 LINCOLNSHIRE DR
BAKERSFIELD CA
93311-9586
US

V. Phone/Fax

Practice location:
  • Phone: 661-834-3600
  • Fax:
Mailing address:
  • Phone: 323-810-0363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: JANETTE DUNIVAN
Title or Position: CEO
Credential: DDS
Phone: 323-810-0363