1750415360 NPI number — DR. MAO HER-FLORES DDS

Table of content: DR. MAO HER-FLORES DDS (NPI 1750415360)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750415360 NPI number — DR. MAO HER-FLORES DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HER-FLORES
Provider First Name:
MAO
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HER
Provider Other First Name:
MAO
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1750415360
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 790
Provider Second Line Business Mailing Address:
650 ZEDIKER AVE.
Provider Business Mailing Address City Name:
PARLIER
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93648-0790
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-646-6618
Provider Business Mailing Address Fax Number:
559-646-6614

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
517 S MADERA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KERMAN
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93630-1523
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-846-6330
Provider Business Practice Location Address Fax Number:
559-842-2375
Provider Enumeration Date:
03/15/2007

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:  47728 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 47728 . This is a "CALIFORNIA DENTAL LIC#" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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