Active NPI
David Willner, DDS
- Dentist
- San Diego, CA
National Provider Identifier
1073706826
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 24891
- Practice address
- 1525 4TH Ave
San Diego, CA 92101-3966 - Phone
- (619) 795-1301
- NPI assigned
- Aug 24, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 24891 | CA | Primary |
Addresses
Primary practice location
1525 4TH Ave
San Diego, CA 92101-3966
Mailing address
8530 La Mesa Blvd
Suite 204
La Mesa, CA 91941-3966
Phone (619) 460-0700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Diego Dental Sleep Therapy, LLC | Past | Accepting new patients | |
| Richard B. Evans, D.D.S., Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Summit Dental of La Mesa
- Dental Clinic/Center
- La Mesa, CA
- NPI 1497048664
-
- Durable Medical Equipment & Medical Supplies
- La Mesa, CA
- NPI 1811259856
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483920000000",
"number": "1073706826",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8530 LA MESA BLVD",
"address_2": "SUITE 204",
"city": "LA MESA",
"state": "CA",
"postal_code": "919413966",
"telephone_number": "619-460-0700",
"fax_number": "619-460-0707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1525 4TH AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921013966",
"telephone_number": "619-795-1301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLNER",
"first_name": "DAVID",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-24",
"last_updated": "2017-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "24891",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.