NPIMap

Organization Active NPI

Wyndhamsmitha ND Kim, a Professional Dental Corporation

  • Dentist
  • Valencia, CA
National Provider Identifier
1215159389
Registry record updated Jul 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
28413 Issued in CA
Legal business name
WYNDHAMSMITHA ND KIM, A PROFESSIONAL DENTAL CORPORATION
Practice address
23838 Valencia Blvd.
Suite #301
Valencia, CA 91355
Phone
(661) 291-1412
Fax
(661) 291-1423
NPI assigned
May 2, 2007
Last updated
Jul 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2012

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

Authorized official

Name
Dr. David R. Wyndhamsmith, D.D.S., M.D.
Title
Owner/Dentist
Phone
(661) 291-1412

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 28413 CA Primary

Addresses

Primary practice location

23838 Valencia Blvd.
Suite #301
Valencia, CA 91355

Mailing address

28097 Smyth Drive
Suite a & C
Valencia, CA 91355
Phone (661) 291-1412

Other names 1

  • VALENCIA DENTAL CARE Other name

National Provider Directory

National Provider Directory
Tax ID family
Valencia Dental Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

23838 Valencia Blvd
Ste 301
Valencia, CA 91355
Phone (661) 255-2511

28097 Smyth Dr
Ste A
Valencia, CA 91355

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341878400000",
    "number": "1215159389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28097 SMYTH DRIVE",
            "address_2": "SUITE A & C",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "91355",
            "telephone_number": "661-291-1412",
            "fax_number": "661-291-1423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23838 VALENCIA BLVD.",
            "address_2": "SUITE #301",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "91355",
            "telephone_number": "661-291-1412",
            "fax_number": "661-291-1423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYNDHAMSMITHA ND KIM, A PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2012-07-10",
        "status": "A",
        "authorized_official_last_name": "WYNDHAMSMITH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "661-291-1412",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "28413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VALENCIA DENTAL CARE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Valencia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.