NPIMap

Organization Active NPI

Olivia Park Dental Corporation

  • Dental Clinic/Center
  • Shafter, CA
National Provider Identifier
1083368765
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
OLIVIA PARK DENTAL CORPORATION
Practice address
1110 E Lerdo Hwy Ste 200
Shafter, CA 93263-9415
Phone
(661) 746-6989
NPI assigned
Feb 10, 2022
Last updated
Feb 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Olivia ParkNPI 1982952198
Title
President
Phone
(337) 424-5950

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

1110 E Lerdo Hwy Ste 200
Shafter, CA 93263-9415

Mailing address

1110 E Lerdo Hwy Ste 200
Shafter, CA 93263-9415
Phone (661) 746-6989

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1083368765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 E LERDO HWY STE 200",
            "city": "SHAFTER",
            "state": "CA",
            "postal_code": "932639415",
            "telephone_number": "661-746-6989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 E LERDO HWY STE 200",
            "city": "SHAFTER",
            "state": "CA",
            "postal_code": "932639415",
            "telephone_number": "661-746-6989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVIA PARK DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "OLIVIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-424-5950"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shafter, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.