Provider Demographics
NPI:1578534046
Name:GIANQUINTO, JARED ROBERT (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:ROBERT
Last Name:GIANQUINTO
Suffix:
Gender:M
Credentials:DMD, MS
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Mailing Address - Street 1:1400 CALLOWAY DR
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-2826
Mailing Address - Country:US
Mailing Address - Phone:661-829-7970
Mailing Address - Fax:888-527-3506
Practice Address - Street 1:1400 CALLOWAY DR
Practice Address - Street 2:SUITE 206
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-2826
Practice Address - Country:US
Practice Address - Phone:661-215-4995
Practice Address - Fax:888-527-3506
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA547561223X0400X
PADS0386361223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics