Individual provider Active NPI

Justin R Deguzman

  • General Practice Dentistry
  • Bakersfield, CA
National Provider Identifier
1780315952
Registry record updated Oct 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
108438 Issued in CA
Practice address
3409 Calloway Dr Ste 401
Bakersfield, CA 93312-2529
Phone
(661) 410-1234
NPI assigned
Jun 20, 2022
Last updated
Oct 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 108438 CA Primary

Addresses

Primary practice location

3409 Calloway Dr Ste 401
Bakersfield, CA 93312-2529

Mailing address

3409 Calloway Dr Ste 401
Bakersfield, CA 93312-2529
Phone (661) 410-1234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
108438CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Vally Transit LLC Current Accepting new patients
Justin Ace Deguzman DMD Inc General Practice Current Accepting new patients
Kids First Dentistry General Practice Past Accepting new patients

Locations

3409 Calloway Dr
Ste 401
Bakersfield, CA 93312
Phone (661) 410-1234

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1655683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790899200000",
    "number": "1780315952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3409 CALLOWAY DR STE 401",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933122529",
            "telephone_number": "661-410-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3409 CALLOWAY DR STE 401",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933122529",
            "telephone_number": "661-410-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGUZMAN",
        "first_name": "JUSTIN",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-20",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "108438",
            "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 Oct 2, 2026; 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.