NPIMap

Organization Active NPI

Ozder Dental Corporation

  • Oral and Maxillofacial Surgery (Dentist)
  • Clovis, CA
National Provider Identifier
1639736762
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
OZDER DENTAL CORPORATION
Practice address
1330 Shaw Ave
Clovis, CA 93612-3985
Phone
(661) 202-0454
NPI assigned
May 23, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Authorized official

Name
Necdet Ozder, DDS
Title
Owner
Phone
(559) 255-1122

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

1330 Shaw Ave
Clovis, CA 93612-3985

Mailing address

1330 Shaw Ave
Clovis, CA 93612-3985
Phone (661) 202-0454

National Provider Directory

National Provider Directory

Locations

1330 Shaw Ave
Clovis, CA 93612
Phone (661) 202-0454

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655769600000",
    "number": "1639736762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 SHAW AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936123985",
            "telephone_number": "661-202-0454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 SHAW AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936123985",
            "telephone_number": "661-202-0454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OZDER DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-23",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A",
        "authorized_official_last_name": "OZDER",
        "authorized_official_first_name": "NECDET",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "559-255-1122",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; 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.