Healthcare Provider Details

I. General information

NPI: 1013575240
Provider Name (Legal Business Name): JESSICA ANNE MAHLMANN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA ANNE PILLONI DDS

II. Dates (important events)

Enumeration Date: 06/03/2019
Last Update Date: 08/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 COFFEE RD
BAKERSFIELD CA
93308-5079
US

IV. Provider business mailing address

10910 GOLDEN VALLEY DR
BAKERSFIELD CA
93311-9122
US

V. Phone/Fax

Practice location:
  • Phone: 661-695-3044
  • Fax:
Mailing address:
  • Phone: 805-208-8225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number103718
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: