Sandy Wissa, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

100002 Issued in CA

Practice address

15747 Pistachio St
Chino Hills, CA 91709-3816

Phone

(909) 438-8487

NPI assigned

Jan 26, 2016

Last updated

Jan 26, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1508223223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15747 PISTACHIO ST",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917093816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15747 PISTACHIO ST",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917093816",
            "telephone_number": "909-438-8487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISSA",
        "first_name": "SANDY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-26",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "100002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Consula Collette Williams
• Jasmine Williams
• Shane Anthony Willis
• Peter Wilton
• Sarah Fabozzi Winter, DMD
• Scott Tae Won, DC
• Andy Wong, DMD
• Iris Lai Wong, LMFT
• James Wong
• Stephanie May Wong, PHARMD

• General Practice Dentistry in Chino Hills, CA
• Providers in Chino Hills, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.