NPIMap

Organization Active NPI

Western Dental Service, Inc

  • Dentist
  • San Bernardino, CA
National Provider Identifier
1922406883
Registry record updated Dec 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
WESTERN DENTAL SERVICE, INC
Practice address
2094 E Highland Ave
San Bernardino, CA 92404-4626
Phone
(909) 388-2420
Fax
(909) 388-2426
NPI assigned
Dec 9, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2014

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

Authorized official

Name
Maribel Zamora
Title
Enrollment Coordinator
Phone
(714) 571-3104

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

2094 E Highland Ave
San Bernardino, CA 92404-4626

Mailing address

530 S Main St
Orange, CA 92868-4525
Phone (714) 480-3000

Other identifiers 1

IdentifierTypeStateIssuer
G90179MedicaidCA

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

2094 E Highland Ave
San Bernardino, CA 92404
Phone (909) 388-2420

NPI Registry JSON

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

{
    "created_epoch": "1418083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418083200000",
    "number": "1922406883",
    "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": "714-480-3000",
            "fax_number": "714-571-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2094 E HIGHLAND AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044626",
            "telephone_number": "909-388-2420",
            "fax_number": "909-388-2426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN DENTAL SERVICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-09",
        "last_updated": "2014-12-09",
        "status": "A",
        "authorized_official_last_name": "ZAMORA",
        "authorized_official_first_name": "MARIBEL",
        "authorized_official_title_or_position": "ENROLLMENT COORDINATOR",
        "authorized_official_telephone_number": "714-571-3104"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G90179",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2014; 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.