NPIMap

Organization Active NPI

Wyndhamsmith and Kim, Aprofessional Dental Corporation

  • Endodontics
  • Valencia, CA
National Provider Identifier
1013139633
Registry record updated Sep 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
46195 Issued in CA
Legal business name
WYNDHAMSMITH AND KIM, APROFESSIONAL DENTAL CORPORATION
Practice address
28097 Smyth Dr. Suite C
Valencia, CA 91355
Phone
(661) 291-1412
Fax
(661) 291-1423
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Patrice A Wyndhamsmith
Title
Office Manager
Phone
(626) 795-9328

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X 46195 CA Primary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X 41122 CA
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X 49312 CA
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X 32384 CA

Addresses

Primary practice location

28097 Smyth Dr. Suite C
Valencia, CA 91355

Mailing address

28097 Smyth Dr. Suite C
Valencia, CA 91355
Phone (661) 799-0925

Other names 1

  • VALENCIA MEDICAL AND DENTAL SPECIALISTS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Valencia Dental Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

28097 Smyth Dr
Ste C
Valencia, CA 91355
Phone (661) 291-1412

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409875200000",
    "number": "1013139633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28097 SMYTH DR. SUITE C",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "91355",
            "telephone_number": "661-799-0925",
            "fax_number": "661-291-1423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28097 SMYTH DR. SUITE C",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "91355",
            "telephone_number": "661-291-1412",
            "fax_number": "661-291-1423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYNDHAMSMITH AND KIM, APROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2014-09-05",
        "status": "A",
        "authorized_official_last_name": "WYNDHAMSMITH",
        "authorized_official_first_name": "PATRICE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "626-795-9328",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "46195",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "41122",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "49312",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "32384",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VALENCIA MEDICAL AND DENTAL SPECIALISTS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Valencia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.