NPIMap

Organization Active NPI

Wilshire Westgate Dental, Inc.

  • Dental Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1619274420
Registry record updated Jan 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
36346 Issued in CA
Legal business name
WILSHIRE WESTGATE DENTAL, INC.
Practice address
11860 Wilshire Blvd
#302
Los Angeles, CA 90025-6613
Phone
(310) 478-3511
NPI assigned
Feb 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2014

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

Authorized official

Name
Dr. Cary Charlin, DDS
Title
Owner
Phone
(310) 478-3511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 36346 CA Primary

Addresses

Primary practice location

11860 Wilshire Blvd
#302
Los Angeles, CA 90025-6613

Mailing address

11860 Wilshire Blvd
#302
Los Angeles, CA 90025-6613
Phone (310) 478-3511

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1297728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389312000000",
    "number": "1619274420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11860 WILSHIRE BLVD",
            "address_2": "#302",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256613",
            "telephone_number": "310-478-3511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11860 WILSHIRE BLVD",
            "address_2": "#302",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256613",
            "telephone_number": "310-478-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSHIRE WESTGATE DENTAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-15",
        "last_updated": "2014-01-10",
        "status": "A",
        "authorized_official_last_name": "CHARLIN",
        "authorized_official_first_name": "CARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-478-3511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "36346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2014; 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.