BEAR VALLEY DENTAL CARE NPI 1093914582

NPI Information

  • NPI: 1093914582
  • Provider Name: BEAR VALLEY DENTAL CARE
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • CLIA Number: 05D0698083
  • Address: 41628 BIG BEAR BLVD
    BIG BEAR LAKE, CA
    ZIP 92315
  • Phone: (909) 866-2646

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NPI Details

BEAR VALLEY DENTAL CARE is a general practice dentist in Big Bear Lake, CA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. BEAR VALLEY DENTAL CARE NPI is 1093914582. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

41628 BIG BEAR BLVD
BIG BEAR LAKE, CA
ZIP 92315
Phone: (909) 866-2646
Fax: (909) 866-1796

The provider's authorized official is Katheryn Bures Poole .
The authorized official title is Owner and has the following contact phone number (909) 866-2646.

The CLIA number assigned to this NPI record is 05D0698083 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 7/13/2007 and was last updated on 7/13/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice40110CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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