DAVID R. WYNDHAMSMITH, A PROFESSIONAL DENTAL CORPORATION (NPI# 1508088675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508088675 |
| Entity Type | Organization |
| Organization Name | DAVID R. WYNDHAMSMITH, A PROFESSIONAL DENTAL CORPORATION |
| Other Organization Name | PASADENA MEDICAL/DENTAL SPECIALIST |
| Practice Address |
1092 E Green St Pasadena CA 91106-2506 |
| Practice Telephone | 6263955140 |
| Practice Fax Number | 6263955144 |
| Mailing Telephone | 6263955140 |
| Mailing Fax Number | 6263955144 |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2015-10-15 |
| Authorized Official Name | MRS. PATRICE A WYNDHAMSMITH (OFFICE MANAGER) |
| Authorized Official Telephone | 6267959328 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0300X |
Dentist Specialization: Periodontics |
41122 | CA | Dental Providers |
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
49312 | CA | Dental Providers |
| N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
37519 | CA | Dental Providers |
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
46195 | CA | Dental Providers |
| Other Name | Type Code |
|---|---|
| Pasadena Medical/Dental Specialist | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881816957 | David R. Wyndhamsmith, A Professional Dental Corporation | Dentist | 1092 E. Green St., Pasadena, CA 91106 | 2007-05-02 |
| Street Address |
1092 E GREEN ST |
| City | PASADENA |
| State | CA |
| Zip Code | 91106-2506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073746228 | Michael Duckhyun Kim | Dentist | 1092 E Green St, Pasadena, CA 91106-2506 | 2009-09-03 |
| 1326271297 | Joseph Chihyun Kim | Dentist | 1092 E Green St, Pasadena, CA 91106-2506 | 2009-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922625987 | Alexa Ann Mettrick | Behavior Technician | 1055 E. Colorado Blcd., Suite 560, Pasadena, CA 91106 | 2020-06-25 |
| 1780205344 | Giovani Telusma | Behavior Technician | 1055 E Colorado Blvd Ste 560 Pasadena, Pasadena, CT 91106 | 2020-05-05 |
| 1356838973 | Susan Ende | Marriage & Family Therapist | 945 Hillcrest Place, Pasadena, CA 91106 | 2018-04-19 |
| 1639678287 | Sean C Velazco | Counselor | 1245 E. Walnut St., Pasadena, CA 91106 | 2018-02-09 |
| 1023558848 | Gregory Ohanian Dds Ms Inc. | Dentist | 225 North Allen Avenue, Pasadena, CA 91106 | 2017-02-27 |
| 1508308586 | Quik Care Express Inc | Non-emergency Medical Transport (VAN) | 592 N. Wilson Ave, 5, Pasadena, CA 91106 | 2016-11-08 |
| 1194119867 | Kimberly Ann Ebner | Dentist | 1060 E. Green St., Suite 105, Pasadena, CA 91106 | 2015-03-20 |
| 1346645512 | Neogenomics Laboratories Inc | Specialist | 840 Cameron Dr, Pasadena, CA 91106 | 2014-10-29 |
| 1255756524 | Tirso Deljunco Sr. | Surgery | 1010 E. Union St., #130, Pasadena, CA 91106 | 2014-02-24 |
| 1386072601 | Hiroko Ogura | Acupuncturist | 1224 E Green St Ste 100, Pasadena, CA 91106 | 2013-10-23 |
| Find all providers in zip 91106 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609117043 | Yoo Kyeom Huh | Dentist | 777 S Marengo Ave Apt 3, Pasadena, CA 91106-4733 | 2013-03-11 |
| 1467763763 | Michelle Anne Hack | Dentist | 8221 Ritchie Hwy, Suite 201, Pasadena, MD 21122-3938 | 2010-07-01 |
| 1326273343 | Irene C. Chang | Dentist | 151 S El Molino Ave Ste 300, Pasadena, CA 91101-2562 | 2009-05-19 |
| 1346443686 | Irene Chang A Professional Dental Corporation | Dentist | 151 S El Molino Ave Ste #300, Pasadena, CA 91101 | 2007-06-06 |
| 1700094208 | J Michael Jann | Dentist | 301 South Fai Oaks Ave, Pasadena, CA 91105 | 2007-05-18 |
| 1497802342 | Younes Safa | Dentist | 960 E Green St Ste 111, Pasadena, CA 91106-2401 | 2007-01-04 |
| 1811076219 | Arnold Takaichi Shibuya | Dentist | 133 S Hudson Ave Ste 1, Pasadena, CA 91101-2614 | 2006-11-04 |
| 1255332391 | Kenneth Mangano | Dentist | 8025 Ritchie Hwy, Suite 204, Pasadena, MD 21122-1031 | 2005-08-10 |
| 1417502592 | Arkady S. Tsibel Dental Corp | Dentist | 181 N Hill Ave, Pasadena, CA 91106-1955 | 2019-08-06 |
| 1861859506 | Ranjivendra Nath Dds Inc | Dentist | 1855 E Colorado Blvd, Pasadena, CA 91107-3554 | 2016-01-26 |
| Find all providers in PASADENA | ||||
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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.