Kristina L. Wiley, DDS, Inc.
Organization Active NPI Dental Clinic/Center · Dixon, CA
NPI 1821398587 · NPPES record last updated Oct 28, 2010
Key facts
- NPI
- 1821398587
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dental Clinic/Center 261QD0000X
- License
- 41149 (CA)
- Legal business name
- KRISTINA L. WILEY, DDS, INC.
- Practice address
- 140 N Jackson St
Suite 1
Dixon, CA 95620-3034 - Phone
- (707) 678-9248
- Fax
- (707) 678-9274
- NPI assigned
- Oct 28, 2010
- Organization subpart
- No
Authorized official
- Name
- Dr. Kristina L. Wiley, D.D.S.
- Title
- Ceo/ Owner
- Phone
- (707) 678-9248
Corporate family (same tax ID) 1
Practitioners 1
-
Kristina Linde Wiley, D.D.S.
National Provider Directory
- Tax ID family
- Kristina L Wiley DDS Inc
Locations
140 N Jackson St
Ste 1
Dixon, CA 95620
Phone (707) 678-9248
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | 41149 | CA | Yes |
Addresses
Primary practice location
140 N Jackson St
Suite 1
Dixon, CA 95620-3034
Mailing address
140 N Jackson St
Suite 1
Dixon, CA 95620-3034
Phone (707) 678-9248
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G9337301 | Medicaid | CA |
Other providers in Dixon, CA
- Melony Rene Johnson
- Mikaela Kalafate
- Gurcharanjit Kaur
- Solji Kim
- Paul T Koenig
- Kristina L. Wiley, DDS, Inc.
- Belen Alejandra Lastra
- Jennifer Lausier
- Sandra D Lee
- Chunhua Chilton Liu
All providers in Dixon, CA · Dental Clinic/Center in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.