NPIMap

Organization Active NPI

Western Dental Services, Inc

  • Dentist
  • San Jose, CA
National Provider Identifier
1295025898
Registry record updated Apr 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
WESTERN DENTAL SERVICES, INC
Practice address
1110 S King Rd
Suite 60
San Jose, CA 95122-2118
Phone
(408) 273-7252
Fax
(408) 273-7270
NPI assigned
Apr 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2011

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

Authorized official

Name
Silvia S Diaz
Title
PPO Coordinator
Phone
(714) 480-3000

Specialties & licenses 1

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

Addresses

Primary practice location

1110 S King Rd
Suite 60
San Jose, CA 95122-2118

Mailing address

530 S Main St
Orange, CA 92868-4525

Other identifiers 1

IdentifierTypeStateIssuer
G92150MedicaidCA

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

Locations

1110 S King Rd
Ste 60
San Jose, CA 95122
Phone (408) 240-0250

NPI Registry JSON

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

{
    "created_epoch": "1302825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302825600000",
    "number": "1295025898",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 S KING RD",
            "address_2": "SUITE 60",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951222118",
            "telephone_number": "408-273-7252",
            "fax_number": "408-273-7270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN DENTAL SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-15",
        "last_updated": "2011-04-15",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "SILVIA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PPO COORDINATOR",
        "authorized_official_telephone_number": "714-480-3000"
    },
    "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": "G92150",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2011; 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.