Healthcare Provider Details

I. General information

NPI: 1265186191
Provider Name (Legal Business Name): CHRISTOPHER J. OVIEDO DDS MS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

380 20TH AVE STE 201
SAN FRANCISCO CA
94121-2221
US

IV. Provider business mailing address

380 20TH AVE STE 201
SAN FRANCISCO CA
94121-2221
US

V. Phone/Fax

Practice location:
  • Phone: 415-752-8330
  • Fax: 415-752-8333
Mailing address:
  • Phone: 415-752-8330
  • Fax: 415-752-8333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTOPHER JON OVIEDO
Title or Position: PRESIDENT
Credential: DDS MS
Phone: 415-203-6875