Healthcare Provider Details

I. General information

NPI: 1861381279
Provider Name (Legal Business Name): MICHAEL ANGELO VILLANUEVA RAMIREZ RDH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2025
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 PHYSICIANS BLVD
BAKERSFIELD CA
93301-1277
US

IV. Provider business mailing address

3614 ELM ST
BAKERSFIELD CA
93301-1511
US

V. Phone/Fax

Practice location:
  • Phone: 833-678-2781
  • Fax:
Mailing address:
  • Phone: 619-483-8093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number102796
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number34127
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: