DR. KONITA LEE WILKS (NPI# 1992119598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992119598 |
| Entity Type | Individual |
| Full Name | DR. KONITA LEE WILKS |
| Credential | D.D.S. |
| Practice Address |
10602 Chapman Ave Garden Grove CA 92840-3146 |
| Mailing Address |
6021 Kenwick Cir Huntington Beach CA 92648-1036 |
| Practice Telephone | 7145370700 |
| Mailing Telephone | 7146425200 |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2015-11-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
63433 | CA | Dental Providers |
| Street Address |
10602 CHAPMAN AVE |
| City | GARDEN GROVE |
| State | CA |
| Zip Code | 92840-3146 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568599769 | Childrens Hospital of Orange County | Clinic/Center | 10602 Chapman Ave, Garden Grove, CA 92840-3103 | 2007-02-27 |
| 1912403965 | Michelle Benitez Rodriguez | Case Manager/Care Coordinator | 10602 Chapman Ave, Garden Grove, CA 92840-3146 | 2018-03-30 |
| 1326563669 | Evelyn Luna | Case Manager/Care Coordinator | 10602 Chapman Ave, Garden Grove, CA 92840-3146 | 2017-08-08 |
| 1417408865 | Danae Davis | Dental Hygienist | 10602 Chapman Ave, Suite 200, Garden Grove, CA 92840-3146 | 2016-10-20 |
| 1841748811 | Lan Pham | Dentist | 10602 Chapman Ave, Suite 200, Garden Grove, CA 92840-3146 | 2016-09-19 |
| 1962959056 | Cristal Sanchez | Case Manager/Care Coordinator | 10602 Chapman Ave, Garden Grove, CA 92840-3146 | 2016-09-06 |
| 1093268005 | Raken Mai | Case Manager/Care Coordinator | 10602 Chapman Ave, Garden Grove, CA 92840-3146 | 2016-07-26 |
| 1023485299 | Les Espinoza | Case Manager/Care Coordinator | 10602 Chapman Ave, Garden Grove, CA 92840-3146 | 2015-08-24 |
| 1023419439 | Boys & Girls Clubs of Garden Grove, Inc. | Case Management | 10602 Chapman Ave, Garden Grove, CA 92840-3146 | 2014-09-05 |
| 1215338694 | Marilyn Jimenez | Case Manager/Care Coordinator | 10602 Chapman Ave, Garden Grove, CA 92840-3146 | 2014-09-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588283808 | Kimberly Gaeta | Behavioral Analyst | 123935 Lewis Street, Ste 202, Garden Grove, CA 92840 | 2020-04-16 |
| 1396397170 | Rosa Cortez | Behavior Technician | 12443 Lewis Street, #201, Garden Grove, CA 92840 | 2019-07-12 |
| 1376005934 | Sekboppa Sor | Nurse Practitioner | An Lanh Free Clinic, 10861 Acacia Pkwy., Garden Grove, CA 92840 | 2019-04-03 |
| 1346730116 | Vinh Le Tran | Pharmacist | 12666 Brookhurst St. Suite 110, Garden Grove, CA 92840 | 2018-05-16 |
| 1841715232 | Scott R. Blair | Physician Assistant | 12828 Harbor Blvd Ste 200, Garden Grove, CA 92840 | 2017-08-07 |
| 1881049492 | Carmen Keally | Dietitian, Registered | 12602 9th St, Garden Grove, CA 92840 | 2016-05-02 |
| 1548688732 | House Call Medical Associates, Inc. | Internal Medicine | 12865 Main St Ste 105, Garden Grove, CA 92840 | 2014-04-03 |
| 1851733059 | Carly Ann Wade | Marriage & Family Therapist | 12755 Brookhurst St. Ste 116, Garden Grove, CA 92840 | 2013-07-29 |
| 1003159864 | Priyal Shah Ohri | Dentist | 10602 Chapman Ave, Suite 200, Garden Grove, CA 92840 | 2013-03-30 |
| 1770853244 | Joseph Pham | Pharmacist | 12001 Euclid St., Garden Grove, CA 92840 | 2011-12-30 |
| Find all providers in zip 92840 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780125518 | Amanda N Siu Dds Inc | Dentist | 12062 Valley View St Ste 250, Garden Grove, CA 92845-1770 | 2017-03-13 |
| 1154745594 | Amanda Siu | Dentist | 12062 Valley View St #250, Garden Grove, CA 92845 | 2014-02-05 |
| 1326103474 | Christina Maldonado | Dentist | 10602 Chapman Ave Ste 200, Garden Grove, CA 92840-3147 | 2006-12-27 |
| 1457837940 | Catherine My-hanh Pham | Dentist | 10602 Chapman Ave Ste 200, Garden Grove, CA 92840-3147 | 2018-07-17 |
| 1962993824 | Gary Gang Liu | Dentist | 10602 Chapman Ave Ste 200, Garden Grove, CA 92840-3147 | 2018-05-25 |
| 1134610454 | Mohammad Abul-fielat Dds Inc | Dentist | 12828 Harbor Blvd Ste 210, Garden Grove, CA 92840-5834 | 2018-05-22 |
| 1346758851 | Mohammad Abul-fielat Dds Inc | Dentist | 9535 Garden Grove Blvd, Ste #201, Garden Grove, CA 92844 | 2018-01-18 |
| 1750713848 | Brandon Gire | Dentist | 10602 Chapman Ave, Garden Grove, CA 92840-3146 | 2013-07-31 |
| 1952698482 | Phi Luong | Dentist | 10602 Chapman Ave Ste 200, Garden Grove, CA 92840-3147 | 2011-07-05 |
| 1417167487 | Eduardo Correa | Dentist | 10602 Chapman Ave Ste 200, Garden Grove, CA 92840-3103 | 2007-05-22 |
| Find all providers in GARDEN GROVE | ||||
| City | GARDEN GROVE |
| Zip Code | 92840 |
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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.