NPIMap

Organization Active NPI

Western Dental Services, Inc.

  • Dentist
  • Canoga Park, CA
National Provider Identifier
1114430824
Registry record updated Nov 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
WESTERN DENTAL SERVICES, INC.
Practice address
21729 Vanowen St
Canoga Park, CA 91303-2618
Phone
(818) 898-0858
Fax
(818) 493-4309
NPI assigned
Nov 16, 2017
Last updated
Nov 16, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2017

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

Authorized official

Name
Maribel Zamora
Title
Enrollment Coordinator
Phone
(714) 571-3104

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X Primary

Addresses

Primary practice location

21729 Vanowen St
Canoga Park, CA 91303-2618

Mailing address

530 S Main St
Orange, CA 92868-4525
Phone (714) 571-3653

Other identifiers 1

IdentifierTypeStateIssuer
G90179MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Western Dental Services Inc278 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1510790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510790400000",
    "number": "1114430824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 S MAIN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684525",
            "telephone_number": "714-571-3653",
            "fax_number": "714-571-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21729 VANOWEN ST",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913032618",
            "telephone_number": "818-898-0858",
            "fax_number": "818-493-4309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN DENTAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-16",
        "last_updated": "2017-11-16",
        "status": "A",
        "authorized_official_last_name": "ZAMORA",
        "authorized_official_first_name": "MARIBEL",
        "authorized_official_title_or_position": "ENROLLMENT COORDINATOR",
        "authorized_official_telephone_number": "714-571-3104"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G90179",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canoga Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.

Verify at the official NPI Registry.