Camarillo Childrens Dental Group

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

036029 Issued in CA

Legal business name

CAMARILLO CHILDRENS DENTAL GROUP

Practice address

3687 Las Posas Rd
Camarillo, CA 93010-1482

Phone

(805) 484-2705

Fax

(805) 484-5908

NPI assigned

Apr 3, 2007

Organization subpart

No

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

Authorized official

Name

Lynn Wan, DDSNPI 1760533889

Title

Partner

Phone

(805) 484-2705

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lynn Wan, DDS

  • Pediatric Dentistry
  • Camarillo, CA
  • NPI 1760533889
  NPD (past) Authorized official
• Vincent Cole Smith

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Camarillo, CA
  • NPI 1427100858
  NPD (past)

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306967567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3687 LAS POSAS RD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930101482",
            "telephone_number": "805-484-2705",
            "fax_number": "805-484-5908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3687 LAS POSAS RD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930101482",
            "telephone_number": "805-484-2705",
            "fax_number": "805-484-5908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMARILLO CHILDRENS DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WAN",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "805-484-2705",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "036029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Nicole Calvillo
• Camarillo All Eyecare Optometry Inc
• Camarillo Ambulatory Surgery Center LLC
• Camarillo Aquatics and Physical Therapy Services Inc
• Camarillo Center for Individual and Family Counseling, Inc.
• Camarillo Community Care, Inc.
• Camarillo Endodontics
• Camarillo Endoscopy Center LLC
• Camarillo Health Care District
• Camarillo Hhca, Inc.

• Pediatric Dentistry in Camarillo, CA
• Providers in Camarillo, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.