NPIMap

Organization Active NPI

J. Whitley Dental Corporation

  • General Practice Dentistry
  • Downey, CA
National Provider Identifier
1013218106
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20487 Issued in CA
Legal business name
J. WHITLEY DENTAL CORPORATION
Practice address
12156 Lakewood Blvd
Downey, CA 90242-2658
Phone
(562) 803-1600
NPI assigned
Nov 5, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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

Authorized official

Name
Brandy Hoffman
Title
Credential Assistant
Phone
(678) 756-5921

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 20487 CA Primary

Addresses

Primary practice location

12156 Lakewood Blvd
Downey, CA 90242-2658

Mailing address

12156 Lakewood Blvd
Downey, CA 90242-2658
Phone (562) 803-1600

Other practice location 1

4428 Slauson Ave
Maywood, CA 90270-2932
Phone (323) 773-1535

National Provider Directory

National Provider Directory

Locations

12156 Lakewood Blvd
Downey, CA 90242
Phone (562) 803-1600

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1288915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675123200000",
    "number": "1013218106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12156 LAKEWOOD BLVD",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902422658",
            "telephone_number": "562-803-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12156 LAKEWOOD BLVD",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902422658",
            "telephone_number": "562-803-1600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4428 Slauson Ave",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "CA",
            "postal_code": "902702932",
            "country_code": "US",
            "telephone_number": "323-773-1535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "J. WHITLEY DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-05",
        "last_updated": "2023-01-31",
        "certification_date": "2022-01-10",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "BRANDY",
        "authorized_official_title_or_position": "CREDENTIAL ASSISTANT",
        "authorized_official_telephone_number": "678-756-5921"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "20487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; 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.