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General NPI Number Information
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NPI Number | 1306406764
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Entity Type | Individual
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Provider Name | BRYCE WILLIAM KINARD DMD
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Gender | Male
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Dates
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Enumeration Date | 06/18/2019
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Last Update Date | 08/30/2023
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Provider Practice Location Address
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Address Line | 801 S VICTORIA AVE STE 201
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City | VENTURA
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State | CA
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Zip | 93003-5371
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Country | US
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Telephone | 805-665-3925
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Fax | 805-665-3926
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Provider Business Mailing Address
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Address Line | 379 COURT AVE
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City | VENTURA
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State | CA
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Zip | 93003-1741
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Country | US
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Telephone | 402-850-5203
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7230
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 108043
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License Number State | CA
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