Healthcare Provider Details

I. General information

NPI: 1346653516
Provider Name (Legal Business Name): BRENDA JOYCE BUZBY DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2014
Last Update Date: 06/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9450 STOCKDALE HWY SUITE 110
BAKERSFIELD CA
93311
US

IV. Provider business mailing address

9450 STOCKDALE HWY SUITE 110
BAKERSFIELD CA
93311
US

V. Phone/Fax

Practice location:
  • Phone: 661-665-0500
  • Fax: 661-665-0710
Mailing address:
  • Phone: 661-665-0500
  • Fax: 661-665-0710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number35377
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: