Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Organization
R. CICCARELLI, DDS., R. JOSEPH, DDS., M. EL FARRA, DDS., D. SAINI, DDS
Active
Organization
R. CICCARELLI, DDS., R. JOSEPH, DDS., M. EL FARRA, DDS., D. SAINI, DDS
Active
Other names
M. Hochhalter, DDS., B. Morehead, DDS., M Bledsoe, DDS, Inc DBA Valley
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BONNIE J MOREHEAD DDS (CORPORATE TREASURER)
(209) 823-9341
Entity
Organization
Contact information
Practice address
1507 W. YOSEMITE, MANTECA, CA 95337
(209) 823-9341
(209) 823-5091
Mailing address
1507 W. YOSEMITE, MANTECA, CA 95337
(209) 823-9341
(209) 823-5091
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
26998
CA
122300000X
Dentist
Primary
28362
CA
122300000X
Dentist
34614
CA
122300000X
Dentist
35699
CA
122300000X
Dentist
38406
CA
122300000X
Dentist
42922
CA
122300000X
Dentist
50181
CA
122300000X
Dentist
51062
CA
122300000X
Dentist
53028
CA
122300000X
Dentist
54048
CA
122300000X
Dentist
59209
CA
Other
Enumeration date
12/05/2006
Last updated
12/29/2011
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