=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659403210
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | A MALHOTRA BAKERSFIELD DENTAL OFFICE, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/09/2007
-----------------------------------------------------
Last Update Date | 05/16/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1900 TRUXTUN AVE # 1
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93301-5032
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-324-7668
-----------------------------------------------------
Fax | 661-324-3662
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1900 TRUXTUN AVE # 1
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93301-5032
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-324-7668
-----------------------------------------------------
Fax | 661-324-3662
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. ADARSH K MALHOTRA
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 661-324-7668
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223E0200X
-----------------------------------------------------
Taxonomy Name | Endodontics
-----------------------------------------------------
License Number | 44024
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------