NPIMap

Organization Active NPI

Western Dental Services, Inc.

  • General Practice Dentistry
  • San Fernando, CA
National Provider Identifier
1902952740
Registry record updated Mar 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
WESTERN DENTAL SERVICES, INC.
Practice address
113 N Maclay Ave
San Fernando, CA 91340-2906
Phone
(818) 365-8334
Fax
(818) 898-3924
NPI assigned
Jan 26, 2007
Last updated
Mar 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2019

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

113 N Maclay Ave
San Fernando, CA 91340-2906

Mailing address

113 N Maclay Ave
San Fernando, CA 91340-2906
Phone (818) 365-8334

Other identifiers 1

IdentifierTypeStateIssuer
G90179-07MedicaidCA

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

Locations

113 N Maclay Ave
San Fernando, CA 91340
Phone (818) 365-8334

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552262400000",
    "number": "1902952740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 N MACLAY AVE",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913402906",
            "telephone_number": "818-365-8334",
            "fax_number": "818-898-3924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 N MACLAY AVE",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913402906",
            "telephone_number": "818-365-8334",
            "fax_number": "818-898-3924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN DENTAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2019-03-11",
        "status": "A",
        "authorized_official_last_name": "TAKKAR",
        "authorized_official_first_name": "PREET",
        "authorized_official_title_or_position": "CHIEF INFORMATION OFFICER",
        "authorized_official_telephone_number": "714-571-3372"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G90179-07",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Fernando, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; 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.