WESTERN DENTAL SERVICES, INC. (NPI# 1740326560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740326560 |
| Entity Type | Organization |
| Organization Name | WESTERN DENTAL SERVICES, INC. |
| Practice Address |
4100 Montgomery Dr Ste. #b Santa Rosa CA 95405-5282 |
| Mailing Address |
530 S Main St Orange CA 92868-4525 |
| Practice Telephone | 7075372020 |
| Practice Fax Number | 7075372025 |
| Mailing Telephone | 7144803000 |
| Mailing Fax Number | 7145713560 |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | CINDY E AVALOS (PPOCOORDINATOR) |
| 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 | G92150-09 | 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 |
4100 MONTGOMERY DR STE. #B |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95405-5282 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851452353 | Jae Sik Hur | Dentist | 4100 Montgomery Dr, Santa Rosa, CA 95405-5282 | 2006-12-12 |
| 1598120305 | Haitham Sami | Dentist | 4100 Montgomery Dr, Santa Rosa, CA 95405-5282 | 2015-12-21 |
| 1336557396 | Maryum Tariq | Dentist | 4100 Montgomery Dr, Santa Rosa, CA 95405-5282 | 2014-07-23 |
| 1316234842 | Yasamin Sariaslani | Dentist | 4100 Montgomery Dr, Ste. A, Santa Rosa, CA 95405-5282 | 2011-07-05 |
| 1750544748 | Wesley Min-da Chiang | Dentist | 4100 Montgomery Dr, Santa Rosa, CA 95405-5282 | 2008-07-09 |
| 1942418264 | Quanli Dong | Dentist | 4100 Montgomery Dr, Suite B, Santa Rosa, CA 95405-5282 | 2007-05-18 |
| 1518003235 | Lata Karir | Dentist | 4100 Montgomery Dr, Suite B, Santa Rosa, CA 95405-5282 | 2007-01-29 |
| 1689736258 | Wonseok Lee | Dentist | 4100 Montgomery Dr, Santa Rosa, CA 95405-5282 | 2006-12-13 |
| 1427110063 | Antoanela Garbacea | Dentist | 4100 Montgomery Dr, Santa Rosa, CA 95405-5282 | 2006-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083230486 | Lizett Camacho | Counselor | 145o Neotomas Avenue Suite 200, Santa Rosa, CA 95405 | 2020-06-22 |
| 1346768918 | Ingrid Tsong | Student in an Organized Health Care Education/Training Program | 3447 Summerfield Road, Santa Rosa, CA 95405 | 2017-09-05 |
| 1275051898 | Jessica Peters Malmberg | Student in an Organized Health Care Education/Training Program | 2447 Summerfield Rd, Santa Rosa, CA 95405 | 2017-09-04 |
| 1306246772 | Kirsten Eckert | Advanced Practice Midwife | 500 Doyle Park Dr Suite 103, Santa Rosa, CA 95405 | 2014-09-03 |
| 1982034294 | Mohammad Reza Saeidi | Dentist | 1820 Sonoma Ave Ste 90a, Santa Rosa, CA 95405 | 2013-11-22 |
| 1851631642 | Debi M. Emmons | Marriage & Family Therapist | 2447 Summerfield Dr, Social Advocates for Youth, Santa Rosa, CA 95405 | 2013-02-15 |
| 1841549979 | Karie Louise Klim | Marriage & Family Therapist | 182 Farmers Ln Ste 204, Santa Rosa, CA 95405 | 2012-09-05 |
| 1427314400 | Rachel E. Page | Counselor | 2447 Summerfield Rd., Santa Rosa, CA 95405 | 2012-04-04 |
| 1689991572 | Center for Integral Healing Inc. | Community Health Worker | 182 Farmers Lane, #203, Santa Rosa, CA 95405 | 2010-04-30 |
| 1588997647 | Kai Morgan | Dentist | 1144 Suite 116 Soonoma Ave, Santa Rosa, CA 95405 | 2009-09-08 |
| Find all providers in zip 95405 | ||||
| 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 |
|---|---|---|---|---|
| 1194369942 | M.s. Salek Dds, A Dental Corporation | Dentist | 2448 Guerneville Rd Ste 1000, Santa Rosa, CA 95403-7226 | 2019-11-05 |
| 1346806791 | Scott C. Bonin D.d.s. A Professional Denal Corporation | Dentist | 1260 N Dutton Ave Ste 290, Santa Rosa, CA 95401-7159 | 2019-05-11 |
| 1285035527 | Jeffers Dentistry Partnership | Dentist | 1820 Sonoma Ave Ste 42, Santa Rosa, CA 95405-6617 | 2014-09-05 |
| 1447699517 | Natalia Camacho-worms | Dentist | 1300 N. Dutton Ave, Santa Rosa, CA 95401 | 2013-06-21 |
| 1205170065 | Yunfei Fan Dds, A Professional Corporation | Dentist | 1420 Guerneville Rd Ste 5, Santa Rosa, CA 95403-4124 | 2012-11-19 |
| 1811231947 | Tingjen Ji | Dentist | 170 Farmers Ln Ste 1, Santa Rosa, CA 95405-4750 | 2012-11-15 |
| 1114295854 | James Klim | Dentist | 2755 Mendocino Ave, Suite 204, Santa Rosa, CA 95403-2827 | 2011-12-08 |
| 1588997647 | Kai Morgan | Dentist | 1144 Suite 116 Soonoma Ave, Santa Rosa, CA 95405 | 2009-09-08 |
| 1700029303 | Richard Anderson Dds | Dentist | 90 Doctors Park Drive, Santa Rosa, CA 95405-9998 | 2009-04-13 |
| 1356506596 | Kenneth James Bauer | Dentist | 55 Mission Cir Ste 107, Santa Rosa, CA 95409-5372 | 2008-07-28 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95405 |
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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.