Old Town Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

OLD TOWN DENTAL

Practice address

20406 Brian Way # 2
Tehachapi, CA 93561-8781

Phone

(661) 822-6706

NPI assigned

Feb 19, 2020

Last updated

Feb 19, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Jones, DDS

Title

Owner/Dentist

Phone

(661) 822-6706

Specialties & licenses 1

Addresses

Locations

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.

• Kevin Tan Bibera, DDS

  • Student in an Organized Health Care Education/Training Program
  • Memphis, TN
  • NPI 1770196024
  NPD

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582070400000",
    "number": "1184257008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20406 BRIAN WAY # 2",
            "city": "TEHACHAPI",
            "state": "CA",
            "postal_code": "935618781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20406 BRIAN WAY # 2",
            "city": "TEHACHAPI",
            "state": "CA",
            "postal_code": "935618781",
            "telephone_number": "661-822-6706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD TOWN DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-19",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "661-822-6706",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Minh Nguyen
• Tomoko Nishida-Castro
• Cristine Norris
• Patrick Joseph O'Connell, M.D.
• Jacquelyn Ohl-Trlica, MFT
• Old Town Dental PC
• Omni Family Health
• Omni Family Health
• Omni Family Health
• Carl Eugene Orr Sr.

• Dental Clinic/Center in Tehachapi, CA
• Providers in Tehachapi, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; 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.