NPIMap

Organization Active NPI

Santa Ynez Valley Vision Source Inc

  • Optometrist
  • Solvang, CA
National Provider Identifier
1124167903
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5812T Issued in CA
Legal business name
SANTA YNEZ VALLEY VISION SOURCE INC
Practice address
2040 Viborg Rd
Suite 240
Solvang, CA 93463-2272
Phone
(805) 688-0707
Fax
(805) 693-9839
NPI assigned
Feb 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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

Authorized official

Name
Dennis R. Bales, O.D.
Title
President
Phone
(805) 688-0707

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 5812T CA Primary

Addresses

Primary practice location

2040 Viborg Rd
Suite 240
Solvang, CA 93463-2272

Mailing address

2040 Viborg Rd
Suite 240
Solvang, CA 93463-2272
Phone (805) 688-0707

Other names 1

  • Santa Ynez Valley Vision Source Optometric Corp Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333324800000",
    "number": "1124167903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 VIBORG RD",
            "address_2": "SUITE 240",
            "city": "SOLVANG",
            "state": "CA",
            "postal_code": "934632272",
            "telephone_number": "805-688-0707",
            "fax_number": "805-693-9839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 VIBORG RD",
            "address_2": "SUITE 240",
            "city": "SOLVANG",
            "state": "CA",
            "postal_code": "934632272",
            "telephone_number": "805-688-0707",
            "fax_number": "805-693-9839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA YNEZ VALLEY VISION SOURCE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2012-04-02",
        "status": "A",
        "authorized_official_last_name": "BALES",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-688-0707",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5812T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Santa Ynez Valley Vision Source Optometric Corp",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Solvang, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; 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.