MEDICARE: JOSHUA R. TWISS, D.D.S., INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	100409	CA

General Provider Information

NPI Number	:	1962927962
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSHUA R. TWISS, D.D.S., INC.

Provider Business Mailing Address
First Line	:	822 HARTZ WAY STE 100
Second Line	:
City	:	DANVILLE
State	:	CA
Zip	:	94526-3433
Country	:	US
Telephone Number	:	925-725-1232
Fax Number	:	925-281-2704

Provider Business Practice Location Address
First Line	:	822 HARTZ WAY STE 100
Second Line	:
City	:	DANVILLE
State	:	CA
Zip	:	94526-3433
Country	:	US
Telephone Number	:	925-725-1232
Fax Number	:	925-281-2704

Authorized Official
Title or Position	:	OWNER
Name	:	JOSHUA RYAN TWISS
Credential	:	DDS
Telephone Number	:	925-725-1232

Provider Enumeration Date	:	08/10/2017
Last Update Date	:	07/21/2022

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