Healthcare Provider Details

I. General information

NPI: 1962508549
Provider Name (Legal Business Name): BERNARD K. KARIAN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 04/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7025 N MAPLE AVE SUITE 108
FRESNO CA
93720-8006
US

IV. Provider business mailing address

7025 N MAPLE AVE SUITE 108
FRESNO CA
93720-8006
US

V. Phone/Fax

Practice location:
  • Phone: 559-226-2722
  • Fax: 559-226-6989
Mailing address:
  • Phone: 559-226-2722
  • Fax: 559-226-6989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number19101
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number19101
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: