Virginia Santiago Williams, PROPHY TECH

Primary specialty

Dental AssistantTaxonomy code 126800000X

Practice address

21 Area Dental Clinic
BLDG 210735 C St
Camp Pendleton, CA 92055-5221

Phone

(760) 725-2569

NPI assigned

Oct 22, 2020

Last updated

Oct 22, 2020By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1770182529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 555221",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555221",
            "telephone_number": "760-725-2569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 AREA DENTAL CLINIC",
            "address_2": "BLDG 210735 C ST",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555221",
            "telephone_number": "760-725-2569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "VIRGINIA",
        "middle_name": "SANTIAGO",
        "credential": "PROPHY TECH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-22",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trina Whiting, REGISTERED NURSE
• Lisa C Whitney, LCSW
• Russell P. Wier, D.O.
• Matthew Clifford Willett, M.D.
• Stephen Craig Williams, PA-C
• John Williamson, MD
• Emanuel Vance Willis, DMD
• Brandon James Wilmot, PA-C
• Justin Andrew Wilson, SOIDC
• Kevin Donald Wilson, DPT

• Dental Assistant in Camp Pendleton, CA
• Providers in Camp Pendleton, CA by specialty
• Dental Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.