Wisdom Teeth Away Incorporated Dental Practice of Juan Jose Alzate D.D

Primary specialty

DentistTaxonomy code 122300000X

License

50558 Issued in CA

Legal business name

WISDOM TEETH AWAY INCORPORATED DENTAL PRACTICE OF JUAN JOSE ALZATE D.D

Practice address

5640 N Fresno Street
Suite 101
Fresno, CA 93710-8330

Phone

(559) 447-5781

Fax

(559) 272-0370

NPI assigned

Aug 16, 2017

Last updated

Mar 15, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Juan Jose Alzate, D.D.S.NPI 1306964366

Title

President

Phone

(559) 447-5781

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Juan Jose Alzate, DDS

  • Dentist
  • Fresno, CA
  • NPI 1306964366
  NPD (past) Authorized official

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

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521072000000",
    "number": "1881110328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5640 N FRESNO STREET",
            "address_2": "SUITE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937108330",
            "telephone_number": "559-447-5781",
            "fax_number": "559-272-0370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5640 N FRESNO STREET",
            "address_2": "SUITE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937108330",
            "telephone_number": "559-447-5781",
            "fax_number": "559-272-0370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISDOM TEETH AWAY INCORPORATED DENTAL PRACTICE OF JUAN JOSE ALZATE D.D",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-16",
        "last_updated": "2018-03-15",
        "status": "A",
        "authorized_official_last_name": "ALZATE",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "JOSE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "559-447-5781",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "50558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Wendell Winter, DO
• Katie Winther
• Georgette George Winton, PHARMD
• James Michael Winton, PHARM.D.
• Max Wirjo, MD
• Wise Soul LLC
• Breana Wise
• Dina Pauline Wise, LMFT
• Sherri Wise
• Thomas Wise

• Dentist in Fresno, CA
• Providers in Fresno, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2018; 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.