NPIMap

Organization Active NPI

Western Dental Services, Inc.

  • Dentist
  • Los Banos, CA
National Provider Identifier
1306489505
Registry record updated Oct 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
WESTERN DENTAL SERVICES, INC.
Practice address
1153 W Pacheco Blvd
Los Banos, CA 93635-8617
Phone
(209) 383-2207
Fax
(209) 383-2363
NPI assigned
Oct 21, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2019

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

Authorized official

Name
Preet Takkar
Title
Chief Information Officer
Phone
(714) 571-3372

Specialties & licenses 1

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

Addresses

Primary practice location

1153 W Pacheco Blvd
Los Banos, CA 93635-8617

Mailing address

530 S Main St
Orange, CA 92868-4525
Phone (714) 480-3000

Other identifiers 1

IdentifierTypeStateIssuer
G86209MedicaidCA

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

1153 W Pacheco Blvd
Los Banos, CA 93635
Phone (209) 383-2207

NPI Registry JSON

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571616000000",
    "number": "1306489505",
    "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": "714-480-3000",
            "fax_number": "714-571-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1153 W PACHECO BLVD",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936358617",
            "telephone_number": "209-383-2207",
            "fax_number": "209-383-2363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN DENTAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-21",
        "last_updated": "2019-10-21",
        "status": "A",
        "authorized_official_last_name": "TAKKAR",
        "authorized_official_first_name": "PREET",
        "authorized_official_title_or_position": "CHIEF INFORMATION OFFICER",
        "authorized_official_telephone_number": "714-571-3372"
    },
    "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": "G86209",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Banos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; 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.