MEDICARE: DR. JOSEPH MEDINA NUNEZ D.D.S.

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	122300000X	Dentist	29735	CA

General Provider Information

NPI Number	:	1992703532
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH MEDINA NUNEZ D.D.S.

Provider Business Mailing Address
First Line	:	1957 19TH ST
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93301-4209
Country	:	US
Telephone Number	:	661-325-6907
Fax Number	:	661-323-2137

Provider Business Practice Location Address
First Line	:	1957 19TH ST
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93301-4209
Country	:	US
Telephone Number	:	661-325-6907
Fax Number	:	661-323-2137

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	07/08/2007

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