1588602767 NPI number — DR. NAOMI JOY HOROWITZ DDS, ABGD, MAGD

Table of content: DR. NAOMI JOY HOROWITZ DDS, ABGD, MAGD (NPI 1588602767)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588602767 NPI number — DR. NAOMI JOY HOROWITZ DDS, ABGD, MAGD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOROWITZ
Provider First Name:
NAOMI
Provider Middle Name:
JOY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS, ABGD, MAGD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588602767
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/10/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
423 CPL EVANS RD.
Provider Second Line Business Mailing Address:
PRESIDIO DENTAL CLINIC
Provider Business Mailing Address City Name:
MONTEREY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93944
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
831-242-5612
Provider Business Mailing Address Fax Number:
831-242-5772

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
423 EVANS RD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONTEREY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93940
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
831-242-5612
Provider Business Practice Location Address Fax Number:
831-277-5772
Provider Enumeration Date:
06/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  17724 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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