HACIENDA DENTAL (NPI# 1275772634) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275772634 |
| Entity Type | Organization |
| Organization Name | HACIENDA DENTAL |
| Other Organization Name | EDWARD H GRUBER DDS |
| Practice Address |
1507 Panama Lane 102 Bakersfield CA 93307 |
| Mailing Address |
4022 Niles St Bakersfield CA 93306-4630 |
| Practice Telephone | 6613985555 |
| Practice Fax Number | 6613985510 |
| Mailing Telephone | 6618713736 |
| Mailing Fax Number | 6618717417 |
| Enumeration Date | 2009-02-09 |
| Last Update Date | 2009-02-09 |
| Authorized Official Name | MYRNA VELASQUEZ (OFFICE MANAGER) |
| Authorized Official Telephone | 6618713736 |
| Is Organization Subpart | Y |
| Parent Organization Name | EDWARD H. GRUBER DDS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
33020 | CA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Edward H Gruber DDS | Other Name - Individual/Organization |
| Street Address |
1507 PANAMA LANE 102 |
| City | BAKERSFIELD |
| State | CA |
| Zip Code | 93307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669936183 | New Leaf Pharmacy Inc | Pharmacy | 2303 S Union Ave Unit E8, Bakersfield, CA 93307 | 2019-01-29 |
| 1740744986 | Dora Robledo | Case Manager/Care Coordinator | 1600 E Belle Terrace Avenue, Bakersfield, CA 93307 | 2019-01-22 |
| 1083107890 | Sabrina Johnson | Case Manager/Care Coordinator | 1600 E Belle Terrance, Bakersfield, CA 93307 | 2018-06-07 |
| 1346799145 | Amandeep Singh | Physical Therapist | 1718 Panama Ln, Appt 904, Bakersfield, CA 93307 | 2016-09-22 |
| 1124478821 | Rafael Gomez | Case Manager/Care Coordinator | 1600 E Belle Terrace, Bakersfield, CA 93307 | 2016-06-14 |
| 1669820098 | Corinne Campbell | Licensed Vocational Nurse | 1010 1/2 South Union, Bakersfield, CA 93307 | 2016-05-26 |
| 1174992523 | Sean Battle Sr. | Case Manager/Care Coordinator | 325 E. Fairview Rd, Bakersfield, CA 93307 | 2015-09-16 |
| 1447634787 | Christina Elizabeth Cortez | Case Manager/Care Coordinator | 1600 E. Belle Terrace, Bakersfield, CA 93307 | 2015-07-16 |
| 1043693252 | Ramon Audelo Jr. | Social Worker | 800 Ming Ave, Bakersfield, CA 93307 | 2015-07-07 |
| 1023415882 | Way'ztown Inc | Non-emergency Medical Transport (VAN) | 1326 E California Ave, Bakersfield, CA 93307 | 2014-11-21 |
| Find all providers in zip 93307 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720559339 | Sayeh Massoumi,dental Corporation | Clinic/Center | 1010 Calloway Dr Ste 200b, Bakersfield, CA 93312-6391 | 2018-12-07 |
| 1467945212 | Ivan Medina-martinez, Dds | Clinic/Center | 3403 Wilson Rd, Bakersfield, CA 93309-5208 | 2018-06-07 |
| 1568776284 | Queiroz Dental Inc | Clinic/Center | 207 H St, Bakersfield, CA 93304-2911 | 2010-08-05 |
| 1104065416 | Edward H. Gruber, Dds | Clinic/Center | 3612 Coffee Rd, A, Bakersfield, CA 93308-5083 | 2009-02-10 |
| 1124282397 | Premier Family Dentistry | Clinic/Center | 2520 H St Ste B, Bakersfield, CA 93301-2800 | 2008-07-16 |
| 1811155609 | Mill Rock Oral Surgery Dental Group | Clinic/Center | 1601 Mill Rock Way # A, Bakersfield, CA 93311-1315 | 2008-05-28 |
| 1265622591 | Le Nguyen Dds, Inc | Clinic/Center | 2217 Niles Pt, Bakersfield, CA 93306-4023 | 2007-08-01 |
| 1831399351 | Edward H. Gruber D.d.s. | Clinic/Center | 1491 White Ln, Bakersfield, CA 93307-4677 | 2007-07-23 |
| 1730786526 | Kathleen Rolfes Dmd, Inc. | Clinic/Center | 500 Old River Rd Ste 155, Bakersfield, CA 93311-9509 | 2020-10-05 |
| 1588273213 | Iliana H. Infante, Dds, Inc | Clinic/Center | 5452 California Ave, Bakersfield, CA 93309-1618 | 2020-07-29 |
| Find all providers in BAKERSFIELD | ||||
| City | BAKERSFIELD |
| Zip Code | 93307 |
Please comment or provide details below to improve the information on HACIENDA DENTAL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.