NPIMap

Organization Active NPI

Hacienda Dental

  • Dental Clinic/Center
  • Bakersfield, CA
National Provider Identifier
1275772634
Registry record updated Feb 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
33020 Issued in CA
Legal business name
HACIENDA DENTAL
Practice address
1507 Panama Lane
102
Bakersfield, CA 93307
Phone
(661) 398-5555
Fax
(661) 398-5510
NPI assigned
Feb 9, 2009
Last updated
Feb 9, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
EDWARD H. GRUBER DDSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 9, 2009

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

Authorized official

Name
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

1507 Panama Lane
102
Bakersfield, CA 93307

Mailing address

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

Other names 1

  • Edward H Gruber DDS Other name

National Provider Directory

National Provider Directory
Tax ID family
Edward H Gruber DDS5 organizations share this tax ID, including this one
Part of
Edward H Gruber DDS

Other organizations with this tax ID 4

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

Locations

1507 Panama Ln
Ste 102
Bakersfield, CA 93307
Phone (661) 398-5555

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 6

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": "1234137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234137600000",
    "number": "1275772634",
    "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": "1507 PANAMA LANE",
            "address_2": "102",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "93307",
            "telephone_number": "661-398-5555",
            "fax_number": "661-398-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HACIENDA DENTAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EDWARD H. GRUBER DDS",
        "enumeration_date": "2009-02-09",
        "last_updated": "2009-02-09",
        "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"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "33020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edward H Gruber DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Feb 9, 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.