Oliver Fernandez Profl Dental Corp

Primary specialty

DentistTaxonomy code 122300000X

License

45688 Issued in CA

Legal business name

OLIVER FERNANDEZ PROFL DENTAL CORP

Practice address

683 Folsom Street
San Francisco, CA 94107

Phone

(415) 777-3337

Fax

(415) 777-3338

NPI assigned

Aug 24, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Oliver M Fernandez, DMDNPI 1649675802

Title

President of Corporation

Phone

(415) 777-3337

Specialties & licenses 1

Addresses

Other names 1

• Oliver Fernandez DMD St Francis General Dentistry Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Oliver Fernandez, DMD

  • Dentist
  • San Francisco, CA
  • NPI 1649675802
  NPD (past) Authorized official

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1578670782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "683 FOLSOM STREET",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94107",
            "telephone_number": "415-777-3337",
            "fax_number": "415-777-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "683 FOLSOM STREET",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94107",
            "telephone_number": "415-777-3337",
            "fax_number": "415-777-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVER FERNANDEZ PROFL DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "OLIVER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT OF CORPORATION",
        "authorized_official_telephone_number": "415-777-3337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "45688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oliver Fernandez DMD St Francis General Dentistry",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Maria Isabel Olivas, DRPH
• Melysa Olivas
• Kimberly Rose Oliveira
• Rodrigo Tavora Oliveira, DC
• Sandra M Oliveira, M.A.
• Hunter Oliver-Allen
• Alex Oliver-Gans
• Leonora Oliver-Williams
• Deborah Kay Oliver-Wilson
• Angie Oliver

• Dentist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.