Dr. Max J Quezada, D.D.S.
Dentist in San Bernardino, CA. Individual provider (NPI-1).
NPI number1265601256
StatusActive
Last updated in NPPESDec 21, 2022
Details
- NPI
- 1265601256
- Entity type
- Individual (NPI-1)
- Name
- Dr. Max J Quezada
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 25, 2008
- Certification date
- Dec 21, 2022
- Last updated
- Dec 21, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 25441 | CA | Yes |
Practice location
3972 N Waterman AveSan Bernardino, CA 92404-1700
Phone 951-264-1733
Mailing address
3972 N Waterman Ave Ste 103San Bernardino, CA 92404-1767
Phone 909-726-1578 · Fax 909-726-1577
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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