Provider Demographics
NPI:1255638896
Name:ELMS, ANDREW (DDS)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:ELMS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3212 SUNVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306-2354
Mailing Address - Country:US
Mailing Address - Phone:661-871-8933
Mailing Address - Fax:
Practice Address - Street 1:3000 WEST CECIL AVENUE
Practice Address - Street 2:KERN VALLEY STATE PRISON
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93216-6000
Practice Address - Country:US
Practice Address - Phone:661-721-6300
Practice Address - Fax:661-721-6334
Is Sole Proprietor?:No
Enumeration Date:2011-02-17
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7605689-9921122300000X
CA60920122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist