Provider Demographics
NPI:1386986164
Name:BANKHARDT, ROBERT DUNCAN (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DUNCAN
Last Name:BANKHARDT
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 1:346 CHELAN CT
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-5343
Mailing Address - Country:US
Mailing Address - Phone:805-527-0146
Mailing Address - Fax:805-527-3302
Practice Address - Street 1:2720 COCHRAN ST
Practice Address - Street 2:SUITE 2-B
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-0701
Practice Address - Country:US
Practice Address - Phone:805-584-1194
Practice Address - Fax:805-584-8191
Is Sole Proprietor?:No
Enumeration Date:2013-03-20
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice