Healthcare Provider Details

I. General information

NPI: 1831616176
Provider Name (Legal Business Name): OH DMD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2017
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2631 FASHION PL STE A
BAKERSFIELD CA
93306-3067
US

IV. Provider business mailing address

PO BOX 10059
BAKERSFIELD CA
93389-0059
US

V. Phone/Fax

Practice location:
  • Phone: 661-323-1111
  • Fax:
Mailing address:
  • Phone: 661-328-0876
  • Fax: 661-327-4733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number44049
License Number StateCA

VIII. Authorized Official

Name: DR. SAEKYU OH
Title or Position: PRESIDENT
Credential: DMD
Phone: 661-328-0876