NPIMap

Organization Active NPI

Western Dental Services, Inc.

  • Dentist
  • Stockton, CA
National Provider Identifier
1487216313
Registry record updated Jul 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
WESTERN DENTAL SERVICES, INC.
Practice address
434 E Dr Martin Luther King Jr Blvd
Stockton, CA 95206-1435
Phone
(209) 643-6170
Fax
(209) 643-6169
NPI assigned
Jul 1, 2019
Last updated
Jul 1, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2019

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

Authorized official

Name
Preet Takkar
Title
Chief Information Officer
Phone
(714) 571-3372

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

434 E Dr Martin Luther King Jr Blvd
Stockton, CA 95206-1435

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
G86209MedicaidCA

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

434 E Dr Martin Luther King Jr Blvd
Stockton, CA 95206
Phone (209) 643-6170

NPI Registry JSON

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

{
    "created_epoch": "1561939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561939200000",
    "number": "1487216313",
    "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": "714-571-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 E DR MARTIN LUTHER KING JR BLVD",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952061435",
            "telephone_number": "209-643-6170",
            "fax_number": "209-643-6169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN DENTAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-01",
        "last_updated": "2019-07-01",
        "status": "A",
        "authorized_official_last_name": "TAKKAR",
        "authorized_official_first_name": "PREET",
        "authorized_official_title_or_position": "CHIEF INFORMATION OFFICER",
        "authorized_official_telephone_number": "714-571-3372"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G86209",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2019; 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.