Healthcare Provider Details

I. General information

NPI: 1053651539
Provider Name (Legal Business Name): OH DMD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2013
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1407 HILLMAN ST
TULARE CA
93274-1600
US

IV. Provider business mailing address

PO BOX 10059
BAKERSFIELD CA
93389-0059
US

V. Phone/Fax

Practice location:
  • Phone: 661-323-1111
  • Fax:
Mailing address:
  • Phone: 661-328-0876
  • Fax: 661-327-4733

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: SAEKYU OH
Title or Position: OWNER/PRESIDENT
Credential: DMD
Phone: 661-232-1111