=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083702658
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JOSHI D.D.S INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/10/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 505 W MORTON AVE
-----------------------------------------------------
City | PORTERVILLE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93257-3303
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-782-8930
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 505 W MORTON AVE
-----------------------------------------------------
City | PORTERVILLE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93257-3303
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-782-8930
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | TREASURER
-----------------------------------------------------
Name | DR. NINA J JOSHI
-----------------------------------------------------
Credential | D.D.S
-----------------------------------------------------
Telephone | 559-782-8930
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 305R00000X
-----------------------------------------------------
Taxonomy Name | Preferred Provider Organization
-----------------------------------------------------
License Number | 50616
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------