NPIMap

Organization Active NPI

Guy W Mendivil DDS Professional Dental Corp

Doing business as Bakersfield Orthodontic Dental Group

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Bakersfield, CA
National Provider Identifier
1255477592
Registry record updated Jun 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
D29737 Issued in CA
Legal business name
GUY W MENDIVIL DDS PROFESSIONAL DENTAL CORP
Doing business as
Bakersfield Orthodontic Dental Group
Practice address
515 W Columbus St Ste Ab
Bakersfield, CA 93301-5846
Phone
(661) 323-5910
NPI assigned
Jan 30, 2007
Last updated
Jun 22, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2015

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

Authorized official

Name
Dr. Guy W Mendivil, DDSNPI 1912054271
Title
Owner
Phone
(661) 323-5910

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
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X D29737 CA Primary

Addresses

Primary practice location

515 W Columbus St Ste Ab
Bakersfield, CA 93301-5846

Mailing address

515 W Columbus St Ste Ab
Bakersfield, CA 93301-5846
Phone (661) 323-5910

Other identifiers 2

IdentifierTypeStateIssuer
G9391401OtherCADENTI-CAL
170062OtherCACGP

Other names 1

  • Bakersfield Orthodontic Dental Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bakersfield Orthodontic Dental Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

515 W Columbus St
Ste Ab
Bakersfield, CA 93301
Phone (661) 323-5910

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": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434931200000",
    "number": "1255477592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 W COLUMBUS ST STE AB",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933015846",
            "telephone_number": "661-323-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 W COLUMBUS ST STE AB",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933015846",
            "telephone_number": "661-323-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUY W MENDIVIL DDS PROFESSIONAL DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2015-06-22",
        "status": "A",
        "authorized_official_last_name": "MENDIVIL",
        "authorized_official_first_name": "GUY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "661-323-5910",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "D29737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "G9391401",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CGP",
            "identifier": "170062",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bakersfield Orthodontic Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 22, 2015; 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.