Willow Glen Dental Specialists

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

WILLOW GLEN DENTAL SPECIALISTS

Practice address

1706 Willow St Ste a
San Jose, CA 95125-5216

Phone

(408) 504-4935

NPI assigned

Sep 28, 2017

Organization subpart

No

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

Authorized official

Name

Rosie Adame

Title

Medical Billing Specialist

Phone

(408) 266-6144

Specialties & licenses 5

Addresses

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

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525910400000",
    "number": "1609385020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 WILLOW ST STE A",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951255216",
            "telephone_number": "408-478-9081",
            "fax_number": "408-904-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 WILLOW ST STE A",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951255216",
            "telephone_number": "408-504-4935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW GLEN DENTAL SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-28",
        "last_updated": "2018-05-10",
        "status": "A",
        "authorized_official_last_name": "ADAME",
        "authorized_official_first_name": "ROSIE",
        "authorized_official_title_or_position": "MEDICAL BILLING SPECIALIST",
        "authorized_official_telephone_number": "408-266-6144"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": "DDS54347",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Willman
• Jennifer Willmes
• Carol Willoughby, R.N.
• Willow Anxiety and Ocd
• Willow Glen Chiropractic
• Willow Glen High
• Willow Glen Medical Foundation
• Willow Glen Middle School
• Willow Glen Optm Physical Therapy
• Willow Glen Primary Care Medicine

• Oral and Maxillofacial Surgery (Dentist) in San Jose, CA
• Providers in San Jose, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2018; 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.