Provider Demographics
NPI:1386712214
Name:VARGAS, FRANK M IX
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:M
Last Name:VARGAS
Suffix:IX
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22535 SECOND STREET
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541
Mailing Address - Country:US
Mailing Address - Phone:510-889-6900
Mailing Address - Fax:510-889-1865
Practice Address - Street 1:22535 2ND ST
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-4111
Practice Address - Country:US
Practice Address - Phone:510-889-6900
Practice Address - Fax:510-889-1865
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA496961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice