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4080 Loma Vista Rd., Ste L. Ventura CA 93003 | |
| (805) 642-2393 | |
| (805) 642-5265 |
| Full Name | |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 4080 Loma Vista Rd., Ste L., Ventura, California |
| Authorized Official Name and Position | William S. Asano (PRESIDENT OF CORPORATION) |
| Authorized Official Contact | 8056422393 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4080 Loma Vista Rd., Ste L. Ventura CA 93003 Ph: (805) 642-2393 | 4080 Loma Vista Rd., Ste L. Ventura CA 93003 Ph: (805) 642-2393 |
| NPI Number | 1295780724 |
|---|---|
| Provider Enumeration Date | 05/23/2006 |
| Last Update Date | 09/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295780724 | NPI | - | NPPES |
| CGP075310 | Medicaid | CA | |
| G93182-01 | Medicaid | CA | |
| 816565 | Other | CA | UNITED CONCORDIA - UCCI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 18677 (California) | Primary |
Jacob Rider Dds Corporation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2437 Harbor Blvd, Ventura, CA 93001 Phone: 805-804-5590 | |
Nanda Specialists: A Dental Group Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3088 Telegraph Rd Ste A, Ventura, CA 93003 Phone: 907-821-1992 | |
Ventura Dental Specialty Group Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3390 Loma Vista Rd, Suite#c, Ventura, CA 93003 Phone: 805-658-0700 Fax: 805-658-0777 |