Healthcare Provider Details

I. General information

NPI: 1356782254
Provider Name (Legal Business Name): CASTEEN DENTAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2013
Last Update Date: 07/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8701 CAMINO MEDIA SUITE A
BAKERSFIELD CA
93311
US

IV. Provider business mailing address

8701 CAMINO MEDIA SUITE A
BAKERSFIELD CA
93311-1335
US

V. Phone/Fax

Practice location:
  • Phone: 661-861-8000
  • Fax: 661-616-5725
Mailing address:
  • Phone: 661-861-8000
  • Fax: 661-616-5725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number35231
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JOY STEEVES
Title or Position: TREATMENT COORDINATOR
Credential:
Phone: 661-861-8000