NPIMap

Organization Active NPI

Western Dental Services, Inc.

  • Dentist
  • Yucaipa, CA
National Provider Identifier
1790416022
Registry record updated Jun 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
WESTERN DENTAL SERVICES, INC.
Practice address
34488 Yucaipa Blvd Ste a
Yucaipa, CA 92399-2482
Phone
(909) 801-8152
Fax
(909) 755-0319
NPI assigned
Jun 17, 2022
Last updated
Jun 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2022

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

Authorized official

Name
Preet Takkar
Title
Chief Operations Officer
Phone
(714) 571-3372

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X Primary

Addresses

Primary practice location

34488 Yucaipa Blvd Ste a
Yucaipa, CA 92399-2482

Mailing address

530 S Main St
Orange, CA 92868-4525
Phone (714) 571-3104

Other identifiers 1

IdentifierTypeStateIssuer
G86209MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Western Dental Services Inc278 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1655424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655424000000",
    "number": "1790416022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 S MAIN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684525",
            "telephone_number": "714-571-3104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34488 YUCAIPA BLVD STE A",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923992482",
            "telephone_number": "909-801-8152",
            "fax_number": "909-755-0319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN DENTAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-17",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A",
        "authorized_official_last_name": "TAKKAR",
        "authorized_official_first_name": "PREET",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "714-571-3372"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G86209",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yucaipa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.