Healthcare Provider Details

I. General information

NPI: 1821906801
Provider Name (Legal Business Name): SHYAM M KRISHNAN DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 N OAK ST STE 2A
VENTURA CA
93001-5688
US

IV. Provider business mailing address

88 N OAK ST STE 2A
VENTURA CA
93001-5688
US

V. Phone/Fax

Practice location:
  • Phone: 805-856-0100
  • Fax:
Mailing address:
  • Phone: 805-856-0100
  • Fax: 805-978-5373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SHYAM M KRISHNAN
Title or Position: OWNER
Credential: DDS
Phone: 805-415-8987