Healthcare Provider Details

I. General information

NPI: 1720916992
Provider Name (Legal Business Name): JUSTIN ACE DEGUZMAN DMD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2026
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3409 CALLOWAY DR STE 401
BAKERSFIELD CA
93312-2529
US

IV. Provider business mailing address

3409 CALLOWAY DR STE 401
BAKERSFIELD CA
93312-2529
US

V. Phone/Fax

Practice location:
  • Phone: 661-410-1234
  • Fax: 661-679-1070
Mailing address:
  • Phone: 661-410-1234
  • Fax: 661-679-1070

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: DR. JUSTIN ACE DEGUZMAN
Title or Position: PRESIDENT
Credential: DMD
Phone: 916-740-0436