WESTERN DENTAL SERVICES, INC. (NPI# 1033683602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033683602 |
| Entity Type | Organization |
| Organization Name | WESTERN DENTAL SERVICES, INC. |
| Practice Address |
3400 Sonoma Blvd Vallejo CA 94590-2972 |
| Mailing Address |
530 S Main St Orange CA 92868-4525 |
| Practice Telephone | 7075544000 |
| Practice Fax Number | 7075546146 |
| Mailing Telephone | 7144803000 |
| Mailing Fax Number | 7145716445 |
| Enumeration Date | 2019-01-17 |
| Last Update Date | 2019-03-28 |
| Authorized Official Name | PREET TAKKAR (CHIEF INFORMATION OFFICER) |
| Authorized Official Telephone | 7145713372 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | G90179 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568063634 | Western Dental Services, Inc. | Dentist | 2537 S Euclid Ave Ste A, Ontario, CA 91762-6620 | 2020-11-05 |
| 1215535141 | Western Dental Services, Inc. | Dentist | 16842 Devonshire St, Granada Hills, CA 91344-7404 | 2020-10-13 |
| 1548876162 | Western Dental Services, Inc. | Dentist | 7046 Broadway, Lemon Grove, CA 91945-1406 | 2020-09-18 |
| 1699388561 | Western Dental Services, Inc. | Dentist | 37134 47th St E Ste A&b, Palmdale, CA 93552-4458 | 2020-08-28 |
| 1659914398 | Western Dental Services, Inc. | Dentist | 1575 N. Grand Ave, Santa Ana, CA 92705-8511 | 2019-10-25 |
| 1306489505 | Western Dental Services, Inc. | Dentist | 1153 W Pacheco Blvd, Los Banos, CA 93635-8617 | 2019-10-21 |
| 1487216313 | Western Dental Services, Inc. | Dentist | 434 E Dr Martin Luther King Jr Blvd, Stockton, CA 95206-1435 | 2019-07-01 |
| 1508426677 | Western Dental Services, Inc. | Dentist | 15515 Normandie Ave, Gardena, CA 90247-4013 | 2019-06-19 |
| 1053975862 | Western Dental Services, Inc. | Dentist | 4834 Etiwanda Ave, Ste 200, Jurupa Valley, CA 91752-1828 | 2019-04-26 |
| 1487112322 | Western Dental Services, Inc. | Dentist | 13368 Main St Ste 300, Hesperia, CA 92345-4730 | 2019-03-11 |
| Street Address |
3400 SONOMA BLVD |
| City | VALLEJO |
| State | CA |
| Zip Code | 94590-2972 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538274998 | Jose Mario Mejia Molina | Dentist | 3400 Sonoma Blvd, Vallejo, CA 94590 | 2006-08-19 |
| 1740325679 | Yarah Beddawi | Dentist | 3400 Sonoma Blvd, Vallejo, CA 94590-2972 | 2007-02-20 |
| 1437213170 | Cherag Dinshaw Sarkari Dds A Dental Corporation | Dentist | 3400 Sonoma Blvd, Vallejo, CA 94590 | 2006-12-20 |
| 1982782918 | Pooja Malik | Dentist | 3400 Sonoma Blvd, Vallejo, CA 94590 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265051445 | Jaspreet Bains | Licensed Vocational Nurse | 508 Alabama Street, Vallejo, CA 94590 | 2020-04-08 |
| 1467097527 | Deneane Hannon | Behavioral Analyst | 238 Georgia St. Ste 102, Vallejo, CA 94590 | 2019-11-13 |
| 1780243196 | Abla Harara Almoraissi | Health Educator | John F. Kennedy Library, 505 Santa Clara St, Vallejo, CA 94590 | 2019-06-10 |
| 1891264461 | Brian Emory Kellogg | Marriage & Family Therapist | 525 Oregon St., Php/iop, Vallejo, CA 94590 | 2018-11-13 |
| 1952801862 | Carica Theresa Saraza Macariola | Specialist/Technologist | 1007 Solano Avenue, Vallejo, CA 94590 | 2018-02-16 |
| 1770007973 | Deborah A Johnson-white | Licensed Vocational Nurse | 908 Tuolumne, Vallejo, CA 94590 | 2017-07-29 |
| 1306378260 | Edgar Diaz | Counselor | 236 Georgia Street Suite 101, Vallejo, CA 94590 | 2017-03-30 |
| 1528440096 | Soren Perry | Counselor | 236 Georgia St., Vallejo, CA 94590 | 2015-06-22 |
| 1518366327 | Kimberly A Holland | Counselor | 631 Tennessee Street Suite 201, Vallejo, CA 94590 | 2014-08-18 |
| 1841605193 | Lawana Lofton | Psychologist | 88 Valle Vista Drive, Unit 6310, Vallejo, CA 94590 | 2014-06-25 |
| Find all providers in zip 94590 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942655055 | Brisbain Rigor Pucan | Dentist | 2143 Springs Rd, #51, Vallejo, CA 94591 | 2016-04-26 |
| 1598172579 | Paul B. Belusko, Dds, A Professional Corporation | Dentist | 125 Plaza Dr Ste 407, Vallejo, CA 94591-3707 | 2014-07-22 |
| 1801212691 | Chunkeun Choi Dds Inc | Dentist | 2121 Redwood St Ste A, Vallejo, CA 94590-3603 | 2014-03-17 |
| 1801162037 | Jerry Annoni | Dentist | 41 Admiral Callaghan Ln Ste F, Vallejo, CA 94591-4000 | 2012-04-02 |
| 1134358021 | Mercedes Aguilar Leoncio | Dentist | 263 Sandy Neck Way, Vallejo, CA 94591-7851 | 2009-07-13 |
| 1316108657 | Western Dental Services, Inc. | Dentist | 3587 Sonoma Blvd, Vallejo, CA 94590-2945 | 2008-06-19 |
| 1588823819 | Wini Zerline Luong | Dentist | 2920 Sonoma Blvd Ste A, Vallejo, CA 94590-3879 | 2008-06-02 |
| 1780841593 | Eugene H Burton IIi | Dentist | 4300 Sonoma Blvd Ste 124, Vallejo, CA 94589-2205 | 2008-05-20 |
| 1073780722 | Nazila Tazangi Edalati | Dentist | 475 Redwood St, 30, Vallejo, CA 94590-2954 | 2008-05-13 |
| 1437348034 | Blake Wesley Mcray | Dentist | 1309 Tennessee St, Vallejo, CA 94590-4645 | 2007-10-18 |
| Find all providers in VALLEJO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.