Healthcare Provider Details

I. General information

NPI: 1942546072
Provider Name (Legal Business Name): INGA KEITHLY O'SHEA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2012
Last Update Date: 07/09/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

937 FRANKLIN BLVD
LEMOORE CA
93246-4700
US

IV. Provider business mailing address

NMRTC LEMOORE 937 FRANKLIN AVENUE
APO AA
93245
US

V. Phone/Fax

Practice location:
  • Phone: 559-998-4215
  • Fax: 559-998-4262
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number8447979-9921
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8447979-9921
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: