Individual provider Active NPI

In Oh, D.D.S

  • General Practice Dentistry
  • Bakersfield, CA
National Provider Identifier
1871742965
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DDS57534 Issued in CA
Practice address
625 34TH St Ste 100&200
Bakersfield, CA 93301-2305
Phone
(833) 678-2781
Fax
(661) 368-0618
NPI assigned
Sep 12, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN 57534 CA
General Practice Dentistry 1223G0001X DDS57534 CA Primary

Addresses

Primary practice location

625 34TH St Ste 100&200
Bakersfield, CA 93301-2305

Mailing address

625 34TH St Ste 100&200
Bakersfield, CA 93301-2305
Phone (833) 678-2781

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240115001639 CA Practitioner - Dentist 3173775954 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS57534CAMDGeneral Practice Dentistry
DN 57534CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Sierra Vista CurrentSince Nov 27, 2023 Accepting new patients
Clinica Sierra Vista CurrentSince Nov 27, 2023 Accepting new patients

Locations

1305 Bear Mountain Blvd
Arvin, CA 93203
Phone (661) 854-3131

625 34th St
Ste 100200
Bakersfield, CA 93301
Phone (661) 328-4284

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1221177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1871742965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 34TH ST STE 100&200",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933012305",
            "telephone_number": "833-678-2781",
            "fax_number": "661-368-0618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 34TH ST STE 100&200",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933012305",
            "telephone_number": "833-678-2781",
            "fax_number": "661-368-0618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OH",
        "first_name": "IN",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-12",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DN 57534",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS57534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.