Westcoast Dental

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

25300 Issued in CA

Legal business name

WESTCOAST DENTAL

Practice address

12730 Hawthorne Blvd Ste D
Hawthorne, CA 90250-3919

Phone

(310) 644-4000

NPI assigned

Jun 11, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Miguel Reyes

Title

Credentialing

Phone

(310) 820-9933

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370908800000",
    "number": "1790123966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12121 WILSHIRE BLVD STE 1111",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12730 HAWTHORNE BLVD STE D",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902503919",
            "telephone_number": "310-644-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTCOAST DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-11",
        "last_updated": "2013-06-11",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "310-820-9933",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "25300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Brina Weiss, PT
• Spencer H Wenger, MD
• West Coast Dental
• West Coast Outpatient Services, Inc
• Danielle Monique West
• Western Dental Services, Inc.
• Western Dental Services, Inc.
• John F. Whitaker, D.D.S.
• Sarah Patricia White, RBT
• Tulisa White

• Dental Hygienist in Hawthorne, CA
• Providers in Hawthorne, CA by specialty
• Dental Hygienist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; 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.