NPIMap

Organization Active NPI

Prosthetic Dentistry

  • Prosthodontics
  • San Francisco, CA
National Provider Identifier
1306975073
Registry record updated Apr 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
Legal business name
PROSTHETIC DENTISTRY
Practice address
450 Sutter St
Suite 1636
San Francisco, CA 94108-4206
Phone
(415) 956-5162
Fax
(415) 956-0166
NPI assigned
Mar 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2012

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

Authorized official

Name
Galen WagnildNPI 1952668204
Title
Partner
Phone
(415) 956-5162

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ProsthodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0700X Primary

Addresses

Primary practice location

450 Sutter St
Suite 1636
San Francisco, CA 94108-4206

Mailing address

450 Sutter St
Suite 1636
San Francisco, CA 94108-4206
Phone (415) 956-5162

National Provider Directory

National Provider Directory

Locations

450 Sutter St
Rm 1636
San Francisco, CA 94108
Phone (415) 956-5162

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334102400000",
    "number": "1306975073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 SUTTER ST",
            "address_2": "SUITE 1636",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941084206",
            "telephone_number": "415-956-5162",
            "fax_number": "415-956-0166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 SUTTER ST",
            "address_2": "SUITE 1636",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941084206",
            "telephone_number": "415-956-5162",
            "fax_number": "415-956-0166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSTHETIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2012-04-11",
        "status": "A",
        "authorized_official_last_name": "WAGNILD",
        "authorized_official_first_name": "GALEN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "415-956-5162"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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.