Individual provider Active NPI

Terry Noble Webber, D.D.S.

  • Dentist
  • Montrose, CA
National Provider Identifier
1417031634
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
23878 Issued in CA
Practice address
2021 Montrose Ave
Suite D
Montrose, CA 91020-1670
Phone
(818) 248-2237
Fax
(818) 248-6873
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 23878 CA Primary

Addresses

Primary practice location

2021 Montrose Ave
Suite D
Montrose, CA 91020-1670

Mailing address

2021 Montrose Ave
Suite D
Montrose, CA 91020-1670
Phone (818) 248-2237

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160216000235 CA Order and Referring Only - DentistPractitioner - Dentist 5193029973

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23878CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417031634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 MONTROSE AVE",
            "address_2": "SUITE D",
            "city": "MONTROSE",
            "state": "CA",
            "postal_code": "910201670",
            "telephone_number": "818-248-2237",
            "fax_number": "818-248-6873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 MONTROSE AVE",
            "address_2": "SUITE D",
            "city": "MONTROSE",
            "state": "CA",
            "postal_code": "910201670",
            "telephone_number": "818-248-2237",
            "fax_number": "818-248-6873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBBER",
        "first_name": "TERRY",
        "middle_name": "NOBLE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "23878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montrose, CA

Sources for this page

Verify at the official NPI Registry.