NPIMap

Organization Active NPI

Western Dental Services, Inc.

  • Dentist
  • Vallejo, CA
National Provider Identifier
1316108657
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
WESTERN DENTAL SERVICES, INC.
Practice address
3587 Sonoma Blvd
Vallejo, CA 94590-2945
Phone
(707) 557-8000
Fax
(707) 557-8030
NPI assigned
Jun 19, 2008
Last updated
Jun 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Authorized official

Name
Cindy E. Avalos
Title
Dentical Assistant Manager
Phone
(714) 480-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

3587 Sonoma Blvd
Vallejo, CA 94590-2945

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
G92150-MedicaidCA

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

3587 Sonoma Blvd
Vallejo, CA 94590
Phone (707) 557-8000

NPI Registry JSON

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

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1316108657",
    "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": "714-571-3598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3587 SONOMA BLVD",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945902945",
            "telephone_number": "707-557-8000",
            "fax_number": "707-557-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN DENTAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-19",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "AVALOS",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "DENTICAL ASSISTANT MANAGER",
        "authorized_official_telephone_number": "714-480-3000"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE 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 Vallejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.