Healthcare Provider Details

I. General information

NPI: 1225946023
Provider Name (Legal Business Name): SHYAM KRISHNAN DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 E MATILIJA ST
OJAI CA
93023-2724
US

IV. Provider business mailing address

304 E MATILIJA ST
OJAI CA
93023-2724
US

V. Phone/Fax

Practice location:
  • Phone: 805-640-2668
  • Fax:
Mailing address:
  • Phone: 805-640-2668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SHYAM MURKOTH KRISHNAN
Title or Position: OWNER
Credential: DDS
Phone: 805-640-2668