Healthcare Provider Details

I. General information

NPI: 1144702184
Provider Name (Legal Business Name): N. OZDER DENTAL PRACTICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2018
Last Update Date: 07/11/2022
Certification Date: 07/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 WIBLE RD
BAKERSFIELD CA
93309-6507
US

IV. Provider business mailing address

1530 E GOLDEN VALLEY WAY
FRESNO CA
93730-3587
US

V. Phone/Fax

Practice location:
  • Phone: 661-396-1701
  • Fax: 661-396-0751
Mailing address:
  • Phone: 661-202-0454
  • Fax: 559-475-0389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NECDET OZDER
Title or Position: OWNER
Credential: DDS
Phone: 661-202-0454