WESTERN DENTAL SERVICES, INC (NPI# 1639467061) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639467061 |
| Entity Type | Organization |
| Organization Name | WESTERN DENTAL SERVICES, INC |
| Practice Address |
780 1st St Gilroy CA 95020-4972 |
| Mailing Address |
530 S Main St Orange CA 92868-4525 |
| Practice Telephone | 4083373620 |
| Practice Fax Number | 4083373670 |
| Mailing Telephone | 7144803000 |
| Mailing Fax Number | 7145713560 |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2011-07-19 |
| Authorized Official Name | SILVIA S DIAZ (PPO COORDINATOR) |
| Authorized Official Telephone | 7144803000 |
| 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 |
|---|---|---|---|---|
| 1952727281 | Western Dental Services, Inc | Dentist | 2200 W Beverly Blvd Ste 400, Montebello, CA 90640-2302 | 2014-03-11 |
| 1235563495 | Western Dental Services, Inc | Dentist | 730 Woollomes Ave, Suite 101-102, Delano, CA 93215-9550 | 2013-08-23 |
| 1912298431 | Western Dental Services, Inc | Dentist | 1310 Churn Creek Rd, Suite E3 - E4, Redding, CA 96003-4004 | 2011-05-02 |
| 1295025898 | Western Dental Services, Inc | Dentist | 1110 S King Rd, Suite 60, San Jose, CA 95122-2118 | 2011-04-15 |
| 1205004124 | Western Dental Services, Inc | Dentist | 19071 Bear Valley Rd., Suite #1, Apple Valley, CA 92308-6709 | 2008-02-13 |
| 1811186463 | Western Dental Services, Inc | Dentist | 1560 W Lacey Blvd Ste 107, Hanford, CA 93230-3587 | 2007-10-19 |
| 1154677763 | Western Dental Services, Inc | Dentist | 4100 S El Camino Real, San Mateo, CA 94403-5131 | 2012-08-01 |
| 1710266887 | Western Dental Services, Inc | Dentist | 1260 Trancas St, Napa, CA 94558-2910 | 2011-08-08 |
| 1871883090 | Western Dental Services, Inc | Dentist | 4242 Beverly Blvd, Los Angeles, CA 90004-4430 | 2011-04-08 |
| Street Address |
780 1ST ST |
| City | GILROY |
| State | CA |
| Zip Code | 95020-4972 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700498722 | Sravana Jyothi Vellaturi | Dentist | 780 1st St, Gilroy, CA 95020-4972 | 2020-08-20 |
| 1376066761 | Ky Nguyen | Dentist | 780 1st St, Gilroy, CA 95020-4972 | 2017-07-18 |
| 1891169124 | Vedasri Thodupunoori | Dentist | 780 1st St, Gilroy, CA 95020-4972 | 2015-11-24 |
| 1386900504 | Vincent Kin Kei Fung | Dentist | 780 1st St, Gilroy, CA 95020-4972 | 2012-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376158105 | Benjamin Liupaogo | Case Manager/Care Coordinator | Rebekah Children's Services, 290 Ioof Ave, Gilroy, CA 95020 | 2020-09-09 |
| 1205457330 | Ethel Rostran | Counselor | 290 I00f Ave., Gilroy, CA 95020 | 2020-04-29 |
| 1407498868 | Mehak Saini | Behavior Technician | 9360 Noname Uno, Gilroy, CA 95020 | 2019-10-16 |
| 1629622899 | Bruce Daniel Pirl | Counselor | 290 Ioof Rebekah Children Ave, 290 Ioof Avenue-phoenix School, Gilroy, CA 95020 | 2019-07-26 |
| 1932752490 | Eamon F. Burke | Counselor | Rebekah Children Services, 290 Ioof Ave., Gilroy, CA 95020 | 2019-07-23 |
| 1578116232 | Jose Enrique Cruz | Behavior Technician | 9360 Noname Uno #130, Gilroy, CA 95020 | 2019-07-22 |
| 1558925560 | Mauricio Hazael Procopio | Behavioral Analyst | 9360 Noname Uno Suite 130, Gilroy, CA 95020 | 2019-04-24 |
| 1689138893 | Gabriela Mendoza | Behavioral Analyst | 9395 Kern Ave, Gilroy, CA 95020 | 2019-01-22 |
| 1972082782 | Andrea Gloria Blanton | Social Worker | Rebekah Children's Services, 290 100f Ave, Gilroy, CA 95020 | 2018-08-13 |
| 1407334626 | Katrina Davina Aguilera | Case Manager/Care Coordinator | 290 Loof Ave., Gilroy, CA 95020 | 2018-07-31 |
| Find all providers in zip 95020 | ||||
| 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 |
|---|---|---|---|---|
| 1154977783 | Suman Ramakumar Dds Inc | Dentist | 6955 Camino Arroyo Ste 50, Gilroy, CA 95020-7342 | 2019-08-09 |
| 1770028367 | Harneet Kaur | Dentist | 835 Sorrento Dr, Gilroy, CA 95020-3239 | 2017-01-05 |
| 1598211062 | Nima Pakravan | Dentist | 6974 Chestnut St, 6974 Automall Pkwy, Gilroy, CA 95020-6635 | 2016-08-25 |
| 1609252097 | Dr. Kim Phung, P. C. | Dentist | 7970 Princevalle St, Gilroy, CA 95020-5027 | 2015-08-07 |
| 1689930869 | Gar N Chan | Dentist | 7880 Wren Ave Ste E154, Gilroy, CA 95020-7802 | 2012-04-02 |
| 1205051224 | Mimi M. Tran | Dentist | 7897 Eigleberry St, Gilroy, CA 95020-5126 | 2007-04-16 |
| 1508990771 | Euwei Michael Tai | Dentist | 7845 Monterey St, Gilroy, CA 95020-4519 | 2007-03-16 |
| 1700940335 | Arnold Tsutomu Ichiuji | Dentist | 700 West Sixth Street, Ste A, Gilroy, CA 95020 | 2006-12-20 |
| 1184782864 | Dental Office of Dawn Pan | Dentist | 8060 Santa Teresa Bl, 120, Gilroy, CA 95020 | 2006-12-05 |
| 1376551358 | Nader Tabibzadeh | Dentist | 7671 Monterey Rd, Gilroy, CA 95020-5215 | 2006-08-04 |
| Find all providers in GILROY | ||||
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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.