NPIMap

Organization Active NPI

Mary Janet C. Roldan, DDS, Inc.

  • Dentist
  • Bakersfield, CA
National Provider Identifier
1902157944
Registry record updated Oct 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
50897 Issued in CA
Legal business name
MARY JANET C. ROLDAN, DDS, INC.
Practice address
4921 Calloway Dr
Ste G-102
Bakersfield, CA 93312-9716
Phone
(661) 369-8989
Fax
(661) 369-8988
NPI assigned
Oct 1, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2012

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

Authorized official

Name
Mary Janet C RoldanNPI 1063414274
Title
President
Phone
(661) 369-8989

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 50897 CA Primary

Addresses

Primary practice location

4921 Calloway Dr
Ste G-102
Bakersfield, CA 93312-9716

Mailing address

4921 Calloway Dr
Ste G-102
Bakersfield, CA 93312-9716
Phone (661) 369-8989

Other names 1

  • Great Smile Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

4921 Calloway Dr
Ste G102
Bakersfield, CA 93312
Phone (661) 369-8989

Practitioners & affiliated clinicians

Practitioners 1

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": "1349049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349049600000",
    "number": "1902157944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4921 CALLOWAY DR",
            "address_2": "STE G-102",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933129716",
            "telephone_number": "661-369-8989",
            "fax_number": "661-369-8988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 CALLOWAY DR",
            "address_2": "STE G-102",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933129716",
            "telephone_number": "661-369-8989",
            "fax_number": "661-369-8988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY JANET C. ROLDAN, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-01",
        "last_updated": "2012-10-01",
        "status": "A",
        "authorized_official_last_name": "ROLDAN",
        "authorized_official_first_name": "MARY JANET",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-369-8989"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "50897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Smile Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 1, 2012; 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.