Healthcare Provider Details

I. General information

NPI: 1922107150
Provider Name (Legal Business Name): KIMBALL GLEN BOND DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 EAST 7TH AVE
CHICO CA
95926
US

IV. Provider business mailing address

181 EAST 7TH AVE
CHICO CA
95926
US

V. Phone/Fax

Practice location:
  • Phone: 530-342-0716
  • Fax: 530-342-9927
Mailing address:
  • Phone: 530-342-0716
  • Fax: 530-342-9927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number24748
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: