Healthcare Provider Details

I. General information

NPI: 1154234045
Provider Name (Legal Business Name): EVAN MARTIN VAN BLARGEN, DDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 W GONZALES RD STE 360
OXNARD CA
93036-0734
US

IV. Provider business mailing address

451 W GONZALES RD STE 360
OXNARD CA
93036-0734
US

V. Phone/Fax

Practice location:
  • Phone: 805-988-4050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: EVAN MARTIN VAN BLARGEN
Title or Position: OWNER
Credential: DDS
Phone: 805-479-2724