NPIMap

Organization Active NPI

Watanabe and Lynn Dental Corporation

  • General Practice Dentistry
  • Lake Elsinore, CA
National Provider Identifier
1396830790
Registry record updated Jun 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
WATANABE AND LYNN DENTAL CORPORATION
Practice address
29273 Central Ave
Ste. a
Lake Elsinore, CA 92532-2254
Phone
(951) 245-8664
Fax
(951) 245-9392
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2009

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

Authorized official

Name
Dr. Bryan Watanabe, DDS
Title
Owner DDS
Phone
(951) 245-8664

Specialties & licenses 1

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

Addresses

Primary practice location

29273 Central Ave
Ste. a
Lake Elsinore, CA 92532-2254

Mailing address

2860 Michelle
2ND Floor
Irvine, CA 92606-1009
Phone (714) 508-3600

Other names 1

  • MARKETPLACE DENTAL GROUP Doing business as

National Provider Directory

National Provider Directory

Locations

29273 Central Ave
Ste A
Lake Elsinore, CA 92532
Phone (951) 245-8664

Practitioners & affiliated clinicians

Practitioners 7

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": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244073600000",
    "number": "1396830790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 MICHELLE",
            "address_2": "2ND FLOOR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926061009",
            "telephone_number": "714-508-3600",
            "fax_number": "714-368-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29273 CENTRAL AVE",
            "address_2": "STE. A",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925322254",
            "telephone_number": "951-245-8664",
            "fax_number": "951-245-9392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATANABE AND LYNN DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2009-06-04",
        "status": "A",
        "authorized_official_last_name": "WATANABE",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "OWNER DDS",
        "authorized_official_telephone_number": "951-245-8664",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARKETPLACE DENTAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Elsinore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2009; 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.