Basic Information
| Provider Information | |||||||||
| NPI: | 1366178162 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SYED | ||||||||
| FirstName: | QANETA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 27552 ARTINE DR | ||||||||
| Address2: | |||||||||
| City: | SANTA CLARITA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913502190 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6616193672 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1403 ALLEN RD STE 1000 | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933149660 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6613680919 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2022 | ||||||||
| LastUpdateDate: | 07/26/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | DDS107434 | CA | Y | Dental Providers | Dentist |
No ID Information.