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General NPI Number Information
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NPI Number | 1881388924
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Entity Type | Individual
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Provider Name | DEREK MAX DOWNING DDS
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Gender | Male
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Dates
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Enumeration Date | 06/02/2023
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 32897 WESTERN HILLS DR STE 102
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City | WINCHESTER
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State | CA
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Zip | 92596-9331
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Country | US
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Telephone | 951-335-5169
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Fax |
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Provider Business Mailing Address
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Address Line | 10613 NE SEASIDE LN
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City | ELGIN
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State | OK
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Zip | 73538-3863
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Country | US
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Telephone | 951-297-0648
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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 | 7765
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DDS111399
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License Number State | CA
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