WESTERN DENTAL SERVICES, INC. (NPI# 1992858062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992858062 |
| Entity Type | Organization |
| Organization Name | WESTERN DENTAL SERVICES, INC. |
| Practice Address |
12649 Poway Rd Poway CA 92064-4415 |
| Mailing Address |
530 S Main St Orange CA 92868-4525 |
| Practice Telephone | 8584866100 |
| Practice Fax Number | 8584864564 |
| Mailing Telephone | 7144803000 |
| Mailing Fax Number | 7145713560 |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. MARINA KING (PPO COORDINATOR) |
| Authorized Official Telephone | 7144803000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | G90179-83 | 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 |
12649 POWAY RD |
| City | POWAY |
| State | CA |
| Zip Code | 92064-4415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114041456 | Louie Haidar | Dentist | 12649 Poway Rd, Poway, CA 92064-4415 | 2007-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194357384 | Prabha Choudhary | Student in an Organized Health Care Education/Training Program | 17555, Corte Lomas Verdes, Poway, CA 92064 | 2020-02-06 |
| 1770143968 | Theresa Marie Morales | In Home Supportive Care | 15352 Running Deer Trl, Poway, CA 92064 | 2019-06-19 |
| 1689230997 | Jaclyn Miller | Audiologist | Health Medical Group, 15525 Pomerado Road Suite C-1, Poway, CA 92064 | 2019-05-13 |
| 1205306842 | Angelita Fuentes | Behavior Technician | 12975 Brookprinter Place Suite 250, Poway, CA 92064 | 2018-11-27 |
| 1396235271 | Michael Cutler, M.d., P.C. | Clinic/Center | 12285 Scripps Poway Pkwy Ste 103, Poway, CA 92064 | 2018-05-16 |
| 1720576671 | Jodi A Mcgrady Dmd, Ms, Adc | Dentist | 12350 Oak Knoll Rd, Poway, CA 92064 | 2018-04-26 |
| 1295237139 | Michelle J. Beaupre | Social Worker | 204 Poway Rd., Poway, CA 92064 | 2018-03-07 |
| 1669918165 | Restore Detox Centers | Substance Abuse Rehabilitation Facility | 14099 Sky Mountain Trail, Poway, CA 92064 | 2017-01-09 |
| 1205382561 | Nightingale Meyou | Pharmacist | 5615 Pomerado Rd, Poway, CA 92064 | 2016-08-28 |
| 1578017232 | Elan Lee | Dentist | 13035 Pomerado Road Suite B, Poway, CA 92064 | 2016-08-11 |
| Find all providers in zip 92064 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154989150 | Kirill Trofimov | Dentist | 15725 Pomerado Rd Ste 204, Poway, CA 92064-2059 | 2019-06-04 |
| 1942682943 | M.l. Aguilar Chavez Dental, Corporation | Dentist | 15525 Pomerado Rd Ste C9, Poway, CA 92064-2426 | 2015-06-25 |
| 1376965954 | Chelsea Liu | Dentist | 12378 Poway Rd, Suite B, Poway, CA 92064-4242 | 2014-01-15 |
| 1245489335 | Marissa Baula Tayag | Dentist | 12222 Poway Rd Ste 6, Poway, CA 92064-4220 | 2008-09-12 |
| 1063612091 | Steven Robert Zisook | Dentist | 14361 Twisted Branch Rd, Poway, CA 92064-1462 | 2007-07-18 |
| 1609086982 | James H. Bright D.d.s., Inc. | Dentist | 15835 Pomerado Rd Ste 201, Poway, CA 92064-2042 | 2007-05-23 |
| 1477769685 | Ning Liu D.d.s. Inc. | Dentist | 12378 Poway Rd Ste B, Poway, CA 92064-4242 | 2007-05-15 |
| 1952523144 | M. Nina Mojaver, Dmd A Dental Corporation | Dentist | 15835 Pomerado Road, Suite 101, Poway, CA 92064 | 2007-05-03 |
| 1487875464 | Derek D. Hyun | Dentist | 13025 Pomerado Road, Suite #b, Poway, CA 92064-4248 | 2007-05-01 |
| 1598986978 | Anu R Rajasekaran | Dentist | 12630 Monte Vista Rd Ste 103, Poway, CA 92064-2526 | 2007-05-01 |
| Find all providers in POWAY | ||||
Please comment or provide details below to improve the information on WESTERN DENTAL SERVICES, INC..
| 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.