Provider Demographics
NPI:1992862379
Name:JOSHIDDSINC
Entity Type:Organization
Organization Name:JOSHIDDSINC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAGANNATH
Authorized Official - Middle Name:G
Authorized Official - Last Name:JOSHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-782-8930
Mailing Address - Street 1:505 W MORTON AVE
Mailing Address - Street 2:
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257-3303
Mailing Address - Country:US
Mailing Address - Phone:559-782-8930
Mailing Address - Fax:559-782-1806
Practice Address - Street 1:505 W MORTON AVE
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-3303
Practice Address - Country:US
Practice Address - Phone:559-782-8930
Practice Address - Fax:559-782-1806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50616122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty