Healthcare Provider Details

I. General information

NPI: 1386745248
Provider Name (Legal Business Name): JOSEPH F FIKTARZ JR. DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8244 EAST 4TH STREET
DOWNEY CA
90241
US

IV. Provider business mailing address

8244 EAST 4TH STREET
DOWNEY CA
90241
US

V. Phone/Fax

Practice location:
  • Phone: 562-923-4543
  • Fax: 562-923-5103
Mailing address:
  • Phone: 562-923-4543
  • Fax: 562-923-5103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number26388
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: