Provider Demographics
NPI:1164518817
Name:WELLS, LINDA TEKAAT (DDS)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:TEKAAT
Last Name:WELLS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20878 SAGE LN
Mailing Address - Street 2:
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561-6423
Mailing Address - Country:US
Mailing Address - Phone:661-822-4861
Mailing Address - Fax:661-822-9212
Practice Address - Street 1:20878 SAGE LN
Practice Address - Street 2:
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561-6423
Practice Address - Country:US
Practice Address - Phone:661-822-4861
Practice Address - Fax:661-822-9212
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS 340141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice