Organization Active NPI

Walia Dental Corporation

  • General Practice Dentistry
  • Tracy, CA
National Provider Identifier
1316515182
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
WALIA DENTAL CORPORATION
Practice address
3101 N Tracy Blvd
Tracy, CA 95376-1717
Phone
(408) 643-5757
NPI assigned
Jun 16, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Authorized official

Name
Dr. Sumanpreet K Walia, DDSNPI 1871826289
Title
Owner Dentist
Phone
(408) 643-5757

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

3101 N Tracy Blvd
Tracy, CA 95376-1717

Mailing address

3101 N Tracy Blvd
Tracy, CA 95376-1717
Phone (408) 643-5757

Other identifiers 1

IdentifierTypeStateIssuer
58823OtherCADENTIST

National Provider Directory

National Provider Directory

Locations

3101 N Tracy Blvd
Tracy, CA 95376
Phone (408) 643-5757

Practitioners & affiliated clinicians

Practitioners 1

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": "1623801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623801600000",
    "number": "1316515182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 N TRACY BLVD",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953761717",
            "telephone_number": "408-643-5757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 N TRACY BLVD",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953761717",
            "telephone_number": "408-643-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALIA DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A",
        "authorized_official_last_name": "WALIA",
        "authorized_official_first_name": "SUMANPREET",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "408-643-5757",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST",
            "identifier": "58823",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tracy, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; 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.