WALTER JEFFERSON DENTAL CORPORATION (NPI# 1437700952) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437700952 |
| Entity Type | Organization |
| Organization Name | WALTER JEFFERSON DENTAL CORPORATION |
| Practice Address |
962 Sepulveda Blvd Harbor City CA 90710-1405 |
| Mailing Address |
17000 Red Hill Ave Irvine CA 92614-5626 |
| Practice Telephone | 3105393245 |
| Mailing Telephone | 7148458890 |
| Mailing Fax Number | 3039520892 |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2019-09-25 |
| Authorized Official Name | WALTER JEFFERSON (OWNER) |
| Authorized Official Telephone | 3105393245 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Harbor City Modern Dentistry Dental Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316291628 | Walter Jefferson Dental Corporation | Dentist | 2740 Pacific Coast Hwy, Torrance, CA 90505-7002 | 2012-11-08 |
| Street Address |
962 SEPULVEDA BLVD |
| City | HARBOR CITY |
| State | CA |
| Zip Code | 90710-1405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548808835 | Michelle Hana Stepanek | Dentist | 962 Sepulveda Blvd, Harbor City, CA 90710-1405 | 2019-12-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164036018 | Eddie Blackmon IIi | Respiratory Therapist, Registered | 25820 Normandie Ave, Harbor City, CA 90710 | 2020-09-08 |
| 1316502099 | Jennifer Ilene Estey | Nurse Practitioner | 1403 Lomita Blvd Ste 307, Harbor City, CA 90710 | 2019-05-07 |
| 1104398643 | Active Life Home Care Inc | In Home Supportive Care | 760 W. Lomita Blvd., Suite 79, Harbor City, CA 90710 | 2018-12-21 |
| 1073088514 | Ez Access Transportation Corp. | Non-emergency Medical Transport (VAN) | 24328 S Vermont Ave, Suite #313, Harbor City, CA 90710 | 2018-10-11 |
| 1689192791 | County of Los Angeles Auditor Controller | Clinic/Center | 1403 Lomita Blvd., Suite 102, Rooms 1-26 & Conference Room, Harbor City, CA 90710 | 2017-09-08 |
| 1174041347 | Cb Carehome, Inc | Skilled Nursing Facility | 23331 Maltby Place, Harbor City, CA 90710 | 2017-09-07 |
| 1649705682 | Gina Guillaume | Student in an Organized Health Care Education/Training Program | 1403 West Lomita Blvd Suite 200, Harbor City, CA 90710 | 2017-04-27 |
| 1760843213 | Karen Savoni | Social Worker | 25975 Normandie Avenue, Harbor City, CA 90710 | 2016-03-11 |
| 1699148593 | Kaiser Permanente | Health Maintenance Organization | 25965 S. Normandie Aveune, Harbor City, CA 90710 | 2015-11-02 |
| 1164778148 | Thermon Lenelle Carrier | Driver | 1332 W. 254th St, Apt E, Harbor City, CA 90710 | 2012-07-27 |
| Find all providers in zip 90710 | ||||
| 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 |
|---|---|---|---|---|
| 1285926683 | Woo Young Lee | Dentist | 1674 Pacific Coast Hwy, Harbor City, CA 90710-2628 | 2011-05-04 |
| 1710195243 | Maritess Tinoco, Dds and Diana Simbol, Dds, A Professional Corporation | Dentist | 1403 W. Lomita Blvd. Suite 306, Harbor City, CA 90710 | 2007-05-18 |
| 1336215219 | Pargev Davtian | Dentist | 1306 W Sepulveda Blvd, Harbor City, CA 90710 | 2006-11-24 |
| 1760580724 | Claudia Romano | Dentist | 1537 Lomita Blvd, Harbor City, CA 90710-2024 | 2006-09-20 |
| 1245628346 | Claudia Romano-hoard, D.d.s., A Professional Dental Corporation | Dentist | 1537 Lomita Blvd, Harbor City, CA 90710-2024 | 2014-12-26 |
| 1326238023 | Andrew Gardner Drollinger | Dentist | 25617 Dodge Ave, Harbor City, CA 90710-3101 | 2007-07-29 |
| 1588877054 | Brian Kiyoshi Shimizu | Dentist | 25617 Dodge Ave, Harbor City, CA 90710-3101 | 2007-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255932141 | Jason T Garland | Dentist | 7892 Sitio Mirto, Carlsbad, CA 92009-6999 | 2020-11-05 |
| 1386245462 | Miller Skinner and Dastrup Dental Corporation of Madera | Dentist | 118 N A St, Madera, CA 93638-3210 | 2020-11-04 |
| 1912508177 | Adrian Acosta Dds A Professional Dental Corp | Dentist | 951 W. Whittier Blvd, La Habra, CA 90631-3743 | 2020-11-04 |
| 1871194175 | Lawrence G. Low Dds & Kenneth Y.k. Li Dds | Dentist | 229 Cajon St Ste 3, Redlands, CA 92373-5284 | 2020-11-03 |
| 1881295384 | Jimmy Nguyen Dds Inc | Dentist | 13089 Peyton Dr. Ste. B, Chino Hills, CA 91709 | 2020-11-03 |
| 1083214282 | Sara Davidson, Dds, PC | Dentist | 176 Terra Vista Ave, San Francisco, CA 94115-3824 | 2020-10-27 |
| 1871192484 | David Moody Dental Corporation | Dentist | 19737 W Valley Blvd, Tehachapi, CA 93561-8601 | 2020-10-23 |
| 1407455181 | Julia Nguyen | Dentist | 9225 Mira Mesa Blvd Ste 218, San Diego, CA 92126-4811 | 2020-10-22 |
| 1104425248 | Aditi Mehndiratta | Dentist | 17585 Vierra Canyon Rd, Prunedale, CA 93907-3312 | 2020-10-20 |
| 1346849452 | Lauren Gabrielle Alfonso Santos | Dentist | 4005 Manzanita Ave Ste 50, Carmichael, CA 95608-1784 | 2020-10-20 |
| Find all providers with the same taxonomy | ||||
| City | HARBOR CITY |
| Zip Code | 90710 |
Please comment or provide details below to improve the information on WALTER JEFFERSON DENTAL CORPORATION.
| 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.