Provider Demographics
NPI:1871616771
Name:OXNARD CHILDRENS DENTAL GROUP
Entity type:Organization
Organization Name:OXNARD CHILDRENS DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETSY
Authorized Official - Middle Name:G
Authorized Official - Last Name:KAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:805-983-0100
Mailing Address - Street 1:451 W. GONZALES ROAD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036
Mailing Address - Country:US
Mailing Address - Phone:805-983-0100
Mailing Address - Fax:805-983-0937
Practice Address - Street 1:451 W GONZALES RD
Practice Address - Street 2:SUITE 300
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-9004
Practice Address - Country:US
Practice Address - Phone:805-983-0100
Practice Address - Fax:805-983-0937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-08
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD236361223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty