NPIMap

Organization Active NPI

Western Dental

  • Dentist
  • Stockton, CA
National Provider Identifier
1144620923
Registry record updated Aug 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
63988 Issued in CA
Legal business name
WESTERN DENTAL
Practice address
1407 W March LN
Stockton, CA 95207-6111
Phone
(209) 473-4000
NPI assigned
Aug 28, 2014
Last updated
Aug 28, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2014

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

Authorized official

Name
Piyush Sisodia
Title
DDS
Phone
(205) 585-6024

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 63988 CA Primary

Addresses

Primary practice location

1407 W March LN
Stockton, CA 95207-6111

Mailing address

626 Adora Cir
Roseville, CA 95678-4404
Phone (205) 585-6024

National Provider Directory

National Provider Directory
Tax ID family
Western Dental4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1407 W March Ln
Stockton, CA 95207
Phone (209) 235-0225

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1409184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409184000000",
    "number": "1144620923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 ADORA CIR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956784404",
            "telephone_number": "205-585-6024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 W MARCH LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076111",
            "telephone_number": "209-473-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-28",
        "last_updated": "2014-08-28",
        "status": "A",
        "authorized_official_last_name": "SISODIA",
        "authorized_official_first_name": "PIYUSH",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "205-585-6024"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.