Healthcare Provider Details

I. General information

NPI: 1194471284
Provider Name (Legal Business Name): JULIA HIGGINS DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2022
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 E 31ST ST
OAKLAND CA
94602-1018
US

IV. Provider business mailing address

1959 NE PACIFIC STREET BOX 357134
SEATTLE WA
98195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 440-591-0256
  • Fax:
Mailing address:
  • Phone: 440-591-0256
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number204E00000X
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: