NPI Code Details Logo

NPI 1205444288

NPI 1205444288 : ALTRUISTIC DENTAL SMILES : HAYWARD, CA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1205444288
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    ALTRUISTIC DENTAL SMILES 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    07/16/2020
-----------------------------------------------------
    Last Update Date     |    07/16/2020
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    163 CYPRESS LOOP 
-----------------------------------------------------
    City                 |    HAYWARD
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    94544-2541
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    510-640-6268
-----------------------------------------------------
    Fax                  |    510-397-0017
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    163 CYPRESS LOOP 
-----------------------------------------------------
    City                 |    HAYWARD
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    94544-2541
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    510-640-6268
-----------------------------------------------------
    Fax                  |    510-397-0017
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER/ GENERAL DENTIST
-----------------------------------------------------
    Name                 |    DR. ANN-CATHERINE PINEDA BAUTISTA 
-----------------------------------------------------
    Credential           |    DMD
-----------------------------------------------------
    Telephone            |    510-640-6268
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    261QD0000X
-----------------------------------------------------
    Taxonomy Name        |    Dental Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.