NPIMap

Organization Active NPI

Wesley Health Centers - Michael Antonovich Dental Clinic

  • Community Health Clinic/Center
  • Pasadena, CA
National Provider Identifier
1801261011
Registry record updated Sep 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
WESLEY HEALTH CENTERS - MICHAEL ANTONOVICH DENTAL CLINIC
Practice address
1845 N Fair Oaks Ave Ste 1101
Pasadena, CA 91103-1620
Phone
(562) 867-7999
Fax
(323) 215-0170
NPI assigned
Dec 14, 2015
Last updated
Sep 3, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
JWCH INSTITUTE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 3, 2021

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

Authorized official

Name
Alvaro Ballesteros
Title
Chief Executive Officer
Phone
(323) 201-4516

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X CA Primary

Addresses

Primary practice location

1845 N Fair Oaks Ave Ste 1101
Pasadena, CA 91103-1620

Mailing address

5650 Jillson St
Commerce, CA 90040-1482
Phone (323) 201-4516

National Provider Directory

National Provider Directory
Tax ID family
Wesley Health Centers - Midnight Mission69 organizations share this tax ID, including this one
Part of
Wesley Health Centers - Midnight Mission

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

Locations

1845 N Fair Oaks Ave
Ste 1101
Pasadena, CA 91103

NPI Registry JSON

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

{
    "created_epoch": "1450051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630627200000",
    "number": "1801261011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5650 JILLSON ST",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900401482",
            "telephone_number": "323-201-4516",
            "fax_number": "323-215-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 N FAIR OAKS AVE STE 1101",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911031620",
            "telephone_number": "562-867-7999",
            "fax_number": "323-215-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESLEY HEALTH CENTERS - MICHAEL ANTONOVICH DENTAL CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JWCH INSTITUTE, INC.",
        "enumeration_date": "2015-12-14",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A",
        "authorized_official_last_name": "BALLESTEROS",
        "authorized_official_first_name": "ALVARO",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "323-201-4516"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; 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.