WILDWOOD DENTAL GROUP (NPI# 1659798262) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659798262 |
| Entity Type | Organization |
| Organization Name | WILDWOOD DENTAL GROUP |
| Practice Address |
3972 N Waterman Ave San Bernardino CA 92404-1700 |
| Mailing Address |
2413 S Grove Ave Ontario CA 91761-6225 |
| Practice Telephone | 9098864864 |
| Mailing Telephone | 9098864864 |
| Enumeration Date | 2014-03-20 |
| Last Update Date | 2014-05-27 |
| Authorized Official Name | IRENE M JUSTIN (PRESIDENT) |
| Authorized Official Telephone | 9098864864 |
| Authorized Official Credential | DDS INC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
51084 | CA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659580249 | Wildwood Dental Group | Dentist | 1617 183rd St Se Ste 1, Mill Creek, WA 98012-6812 | 2007-05-21 |
| Street Address |
3972 N WATERMAN AVE |
| City | SAN BERNARDINO |
| State | CA |
| Zip Code | 92404-1700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922192707 | Mehta Dental Corporation | Dentist | 3972 N Waterman Ave, Ste. 110, San Bernardino, CA 92404-1700 | 2006-10-03 |
| 1558981381 | Blessing Community Health Center | Preventive Medicine | 3972 N Waterman Ave, San Bernardino, CA 92404-1700 | 2020-04-22 |
| 1619409554 | Ash M Dason Dds, A Proffesional Dental Corp | Dentist | 3972 N Waterman Ave, Suit 110, San Bernardino, CA 92404-1700 | 2017-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740849363 | Danniella Alexandra Murillo | Physician Assistant | 2101 North Waterman Ave, San Bernardino, CA 92404 | 2019-06-07 |
| 1902377484 | Shauntel Renee Nelson | Student in an Organized Health Care Education/Training Program | 1481 N. Windsor Dr., San Bernardino, CA 92404 | 2018-12-10 |
| 1487123584 | Garrett M Grigg | Licensed Psychiatric Technician | 1481 N Windsor Dr, San Bernardino, CA 92404 | 2018-11-19 |
| 1881163434 | James Dean Anders | Counselor | 1481 Windsor Drive, San Bernardino, CA 92404 | 2018-11-13 |
| 1043703564 | Samantha Makpaiboonvatana | Optometrist | 1909 N Waterman Ave Ste 3, San Bernardino, CA 92404 | 2018-06-09 |
| 1861981623 | Christopher Windham | Behavior Technician | 2460 Fremontia Dr, San Bernardino, CA 92404 | 2018-05-08 |
| 1891145041 | Cynthia Lusy Gastelum | Marriage & Family Therapist | 1885 E Lynwood Dr Rm Se3, San Bernardino, CA 92404 | 2016-06-20 |
| 1336598259 | Foundation Enterprises LLC | Non-emergency Medical Transport (VAN) | 1663 Date Pl., #30390, San Bernardino, CA 92404 | 2016-06-10 |
| 1881042877 | Helen Ann Thompson | Speech-Language Pathologist | 1311 E. State St., San Bernardo, CA 92404 | 2016-05-31 |
| 1366839938 | Lanecia Richardson | Counselor | 135 Paul Drive, San Rafeal, CA 92404 | 2015-04-22 |
| Find all providers in zip 92404 | ||||
| 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 |
|---|---|---|---|---|
| 1124639901 | Arutyun Mkrtchyan D.d.s. Inc | Dentist | 1655 N Mount Vernon Ave Unit B, San Bernardino, CA 92411-1427 | 2020-08-13 |
| 1316555261 | Ryan Andrew Stitzinger | Dentist | 234 N D St, San Bernardino, CA 92401-1702 | 2020-07-16 |
| 1417506932 | Rincon Dds and Associates Inc | Dentist | 1078 E Hospitality Ln, San Bernardino, CA 92408-2878 | 2019-09-06 |
| 1669036117 | Feldkamp Cal Select Dental Group, Inc. | Dentist | 164 W Hospitality Ln Ste 127, San Bernardino, CA 92408-3316 | 2019-04-30 |
| 1609358845 | Arteaga Dental Corporation | Dentist | 494 S Rancho Ave, San Bernardino, CA 92410-2144 | 2018-09-04 |
| 1295213239 | Feldkamp Cal Select Dental Group, Inc. | Dentist | 164 W Hospitality Ln # 107, San Bernardino, CA 92408-3316 | 2018-08-01 |
| 1508370487 | Katy Chou Dds Inc | Dentist | 1799 N Waterman Ave Ste C, San Bernardino, CA 92404-5107 | 2017-11-29 |
| 1700309184 | Eric Williamson | Dentist | 328 Commercial Rd Ste 104, San Bernardino, CA 92408-3766 | 2017-07-18 |
| 1841741360 | Esther Song | Dentist | 2672 S Carl Pl, San Bernardino, CA 92408-4182 | 2016-10-19 |
| 1578916029 | Alexander Reimann | Dentist | 2665 Annapolis Cir, San Bernardino, CA 92408-4133 | 2016-07-20 |
| Find all providers in SAN BERNARDINO | ||||
| City | SAN BERNARDINO |
| Zip Code | 92404 |
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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.