NPIMap

Organization Active NPI

Dental Depot

  • Dental Clinic/Center
  • Bakersfield, CA
National Provider Identifier
1205169729
Registry record updated Sep 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
33020 Issued in CA
Legal business name
DENTAL DEPOT
Practice address
4022 Niles St
Bakersfield, CA 93306-4630
Phone
(661) 871-3736
Fax
(661) 871-7417
NPI assigned
Sep 16, 2009
Organization subpart
Yes
Parent organization
EDWARD H. GRUBER DDSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 16, 2009

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

Authorized official

Name
Mrs. Myrna Velasquez
Title
Office Manager
Phone
(661) 871-3736

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 33020 CA Primary

Addresses

Primary practice location

4022 Niles St
Bakersfield, CA 93306-4630

Mailing address

4022 Niles St
Bakersfield, CA 93306-4630
Phone (661) 871-3736

National Provider Directory

National Provider Directory
Tax ID family
Dental Depot5 organizations share this tax ID, including this one
Part of
Dental Depot

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

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": "1253059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253059200000",
    "number": "1205169729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4022 NILES ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933064630",
            "telephone_number": "661-871-3736",
            "fax_number": "661-871-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4022 NILES ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933064630",
            "telephone_number": "661-871-3736",
            "fax_number": "661-871-7417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL DEPOT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EDWARD H. GRUBER DDS",
        "enumeration_date": "2009-09-16",
        "last_updated": "2009-09-16",
        "status": "A",
        "authorized_official_last_name": "VELASQUEZ",
        "authorized_official_first_name": "MYRNA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "661-871-3736",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "33020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; 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.