NPIMap

Organization Active NPI

Von Westernhagen Dental Corporation

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1790349751
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
VON WESTERNHAGEN DENTAL CORPORATION
Practice address
520 E Manchester Ave
Los Angeles, CA 90003-3525
Phone
(323) 521-5444
NPI assigned
Apr 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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

Authorized official

Name
Ericka Soto
Title
Lead Provider Relations Specialist
Phone
(312) 274-4581

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

520 E Manchester Ave
Los Angeles, CA 90003-3525

Mailing address

350 N Clark St Ste 600
Chicago, IL 60654-4782
Phone (312) 274-4526

Other names 1

  • CanAm Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Canam Dental9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

536 E Manchester Ave
Los Angeles, CA 90003

520 E Manchester Ave
Los Angeles, CA 90003
Phone (323) 521-5444

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643328000000",
    "number": "1790349751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N CLARK ST STE 600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606544782",
            "telephone_number": "312-274-4526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E MANCHESTER AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900033525",
            "telephone_number": "323-521-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VON WESTERNHAGEN DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-25",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A",
        "authorized_official_last_name": "SOTO",
        "authorized_official_first_name": "ERICKA",
        "authorized_official_title_or_position": "LEAD PROVIDER RELATIONS SPECIALIST",
        "authorized_official_telephone_number": "312-274-4581"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CanAm Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 28, 2022; 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.