Healthcare Provider Details
I. General information
NPI: 1699648485
Provider Name (Legal Business Name): YULIANA CISNEROS MUNOZ RDH, EFDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/26/2025
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
625 34TH ST STE 100&200
BAKERSFIELD CA
93301-2305
US
IV. Provider business mailing address
9705 CRYSTAL FALLS LN
SHAFTER CA
93263-2283
US
V. Phone/Fax
- Phone: 833-678-2781
- Fax: 661-368-0618
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 126800000X |
| Taxonomy | Dental Assistant |
| License Number | 36212 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 124Q00000X |
| Taxonomy | Dental Hygienist |
| License Number | 36229 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: