Healthcare Provider Details

I. General information

NPI: 1336206788
Provider Name (Legal Business Name): JOSE DAVID SANCHEZ DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 12/14/2021
Certification Date: 12/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20370 W VALLEY BLVD
TEHACHAPI CA
93561-8615
US

IV. Provider business mailing address

20370 W VALLEY BLVD
TEHACHAPI CA
93561-8615
US

V. Phone/Fax

Practice location:
  • Phone: 661-822-3727
  • Fax: 661-822-4529
Mailing address:
  • Phone: 661-822-3727
  • Fax: 661-822-4529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number25836
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number25836
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: