Healthcare Provider Details

I. General information

NPI: 1568689883
Provider Name (Legal Business Name): DANIEL T. HEFELFINGER PH.D. , D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 LOMA VISTA RD # 5
VENTURA CA
93003-3033
US

IV. Provider business mailing address

3400 LOMA VISTA RD # 5
VENTURA CA
93003-3033
US

V. Phone/Fax

Practice location:
  • Phone: 805-642-5196
  • Fax: 805-642-1210
Mailing address:
  • Phone: 805-642-5196
  • Fax: 805-642-1210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number27437
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: