Organization Active NPI

Sanford L. Ratner DDS and Monty C.Wilson DDS Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • Santa Ana, CA
National Provider Identifier
1154514388
Registry record updated Sep 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
027058 Issued in CA
Legal business name
SANFORD L. RATNER DDS AND MONTY C.WILSON DDS INC.
Practice address
1200 N Tustin Ave
Suite 108
Santa Ana, CA 92705-3508
Phone
(714) 835-7771
Fax
(714) 835-1715
NPI assigned
Aug 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2011

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

Authorized official

Name
Dr. Sanford L Ratner, DDSNPI 1922178672
Title
President of Corp.
Phone
(714) 835-7771

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 027058 CA Primary

Addresses

Primary practice location

1200 N Tustin Ave
Suite 108
Santa Ana, CA 92705-3508

Mailing address

1200 N Tustin Ave
Suite 108
Santa Ana, CA 92705-3508
Phone (714) 835-7771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080416000252 CA Part B Supplier - Clinic/Group Practice 1850479858 Receives reassigned benefits from 3 practitioners
Practice locations: Santa Ana, CA; Orange, CA

National Provider Directory

National Provider Directory

Locations

436 S Glassell St
Orange, CA 92866
Phone (714) 633-6060

1200 N Tustin Ave
Ste 108
Santa Ana, CA 92705
Phone (714) 835-7771

Practitioners & affiliated clinicians

Practitioners 4

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": "1187654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317168000000",
    "number": "1154514388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N TUSTIN AVE",
            "address_2": "SUITE 108",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053508",
            "telephone_number": "714-835-7771",
            "fax_number": "714-835-1715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N TUSTIN AVE",
            "address_2": "SUITE 108",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053508",
            "telephone_number": "714-835-7771",
            "fax_number": "714-835-1715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANFORD L. RATNER DDS AND MONTY C.WILSON DDS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-21",
        "last_updated": "2011-09-28",
        "status": "A",
        "authorized_official_last_name": "RATNER",
        "authorized_official_first_name": "SANFORD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT OF CORP.",
        "authorized_official_telephone_number": "714-835-7771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "027058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.