NPIMap

Organization Active NPI

Western Dental Services, Inc.

  • Dentist
  • South Gate, CA
National Provider Identifier
1255859823
Registry record updated Sep 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
WESTERN DENTAL SERVICES, INC.
Practice address
4424 Tweedy Blvd
South Gate, CA 90280-6304
Phone
(323) 564-4444
NPI assigned
Sep 5, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 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
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

4424 Tweedy Blvd
South Gate, CA 90280-6304

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": "1504569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504569600000",
    "number": "1255859823",
    "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": "4424 TWEEDY BLVD",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902806304",
            "telephone_number": "323-564-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN DENTAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-05",
        "last_updated": "2017-09-05",
        "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": "193200000X MULTI-SPECIALTY 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 South Gate, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.