WEST COAST DENTAL (NPI# 1801186556) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801186556 |
| Entity Type | Organization |
| Organization Name | WEST COAST DENTAL |
| Practice Address |
1330 Shaw Ave Ste 103 Clovis CA 93612-3985 |
| Practice Telephone | 5593256161 |
| Mailing Telephone | 5593256161 |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2011-04-14 |
| Authorized Official Name | MICHAEL SHAUN CREDILLE (REGISTERED DENTAL ASSISTANT) |
| Authorized Official Telephone | 5593256161 |
| Authorized Official Credential | RDA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 126800000X | Dental Assistant | 75261 | CA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730578063 | West Coast Dental | Dental Assistant | 3571 N 1st St Ste 203, San Jose, CA 95134-1803 | 2015-01-09 |
| 1043434988 | West Coast Dental | Dentist | 595 W 8th Ave, Eugene, OR 97401-2806 | 2007-04-12 |
| 1932323607 | West Coast Dental | Dentist | 1050 W Elm Ave Ste 230, Hermiston, OR 97838-2714 | 2007-04-12 |
| 1538638796 | West Coast Dental | Dental Hygienist | 12730 Hawthorne Blvd Ste D, Hawthorne, CA 90250-3919 | 2018-11-16 |
| 1699936575 | West Coast Dental | Dentist | 732 Sw 3rd Ave, Suite 202, Portland, OR 97204-2416 | 2008-06-23 |
| 1073717781 | West Coast Dental | Dentist | 1740 W 17th Ave, Eugene, OR 97402-3619 | 2007-06-14 |
| 1285858027 | West Coast Dental | Dentist | 1880 Lancaster Dr Ne Ste 121, Salem, OR 97305-1069 | 2007-04-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | WEST COAST DENTAL ARTS | 159 Medford Ave, Hayward, CA 94541-1748 |
| Washington State Corporations | WEST COAST DENTAL GROUP LIMITED LIABILITY COMPANY | 1002 Harvey Rd, Auburn, WA 98002 |
| Oregon Corporations, Companies and Business Names | WEST COAST DENTAL LAB | 5935 Darcy St Se, Salem, OR 97306 |
| Oregon Corporations, Companies and Business Names | WEST COAST DENTAL REPAIR AND SALES. | 1698 Carton Way, Grants Pass, OR 97526 |
| Street Address |
1330 SHAW AVE STE 103 |
| City | CLOVIS |
| State | CA |
| Zip Code | 93612-3985 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275837866 | Leann Renee White | Dental Assistant | 1330 Shaw Ave Ste 103, Clovis, CA 93612-3985 | 2010-12-22 |
| 1306277264 | Denali Knudson | Dental Hygienist | 1330 Shaw Ave Ste 103, Clovis, CA 93612-3985 | 2013-12-03 |
| 1003259839 | Hilda Jeanette Garza | Dental Assistant | 1330 Shaw Ave Ste 103, Clovis, CA 93612-3985 | 2013-04-11 |
| 1417293150 | Jodeci Rincon | Dental Assistant | 1330 Shaw Ave Ste 103, Clovis, CA 93612-3985 | 2012-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235778002 | Prieto Dental Corporation | Dentist | 2320 Clovis Avenue, Suite 102, Clovis, CA 93612 | 2019-12-27 |
| 1285190827 | Natividad Casillas | Behavior Technician | 20 N Dewitt, Clovis, CA 93612 | 2019-02-19 |
| 1922578988 | Benjamin Harold Davis Jr. | Behavior Technician | Swans Consulting, 20 N Dewitt Ave, Clovis, CA 93612 | 2018-12-03 |
| 1134620651 | Innovative Development & Living Solutions of California | Assisted Living Facility | 32 West Sierra Ave, Clovis, CA 93612 | 2018-02-21 |
| 1427578616 | Mariamajane Sengsiri | Licensed Vocational Nurse | 1244 Estabrook Ave., Clovis, CA 93612 | 2017-06-20 |
| 1417482464 | Tiffanie Guy | Pharmacist | 2810 Willow Ave Apt 206, Clovis, CA 93612 | 2017-04-27 |
| 1194271833 | Daniel Salinas | Specialist/Technologist | 1712 Harvard Ave., Clovis, CA 93612 | 2016-09-01 |
| 1386071447 | Darra Hirsh | Psychologist | 334 Shaw Ave Ste 100, Clovis, CA 93612 | 2013-10-03 |
| 1437400793 | Bashful Elephant | Counselor | 3097 Willow Suite 4, Clovis, CA 93612 | 2012-09-27 |
| 1588930432 | Nghiem Gia Vu | Pharmacist | 695 W Herdn Ave, Clovis, CA 93612 | 2012-03-26 |
| Find all providers in zip 93612 | ||||
| Taxonomy Code | 126800000X |
| Grouping | Dental Providers |
| Classification | Dental Assistant |
| An individual who may or may not have completed an accredited dental assisting education program and who aids the dentist in providing patient care services and performs other nonclinical duties in the dental office or other patient care facility. The scope of the patient care functions that may be legally delegated to the dental assistant varies based on the needs of the dentist the educational preparation of the dental assistant and state dental practice acts and regulations. Patient care services are provided under the supervision of a dentist. To avoid misleading the public, no occupational title other than dental assistant should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356972897 | Nicole Hammes | Dental Assistant | 2497 Herndon Ave, Clovis, CA 93611-8976 | 2020-02-03 |
| 1396217998 | Melissa Nickeson | Dental Assistant | 1900 Shaw Ave Ste 101, Clovis, CA 93611-4209 | 2018-12-19 |
| 1275837866 | Leann Renee White | Dental Assistant | 1330 Shaw Ave Ste 103, Clovis, CA 93612-3985 | 2010-12-22 |
| 1912208901 | Fatimah Aisha Allen | Dental Assistant | 1330 Shaw Ave Ste 101, Clovis, CA 93612-3985 | 2010-11-08 |
| 1023321262 | Melanie Beth Quillen | Dental Assistant | 81 W San Jose Ave, Clovis, CA 93612-2460 | 2010-07-16 |
| 1225274400 | Christina M Vidal | Dental Assistant | 200 W Shaw, 110, Clovis, CA 93612 | 2008-12-18 |
| 1972064079 | Marie James | Dental Assistant | 1900 Shaw Ave Ste 101, Clovis, CA 93611-4209 | 2019-03-29 |
| 1003259839 | Hilda Jeanette Garza | Dental Assistant | 1330 Shaw Ave Ste 103, Clovis, CA 93612-3985 | 2013-04-11 |
| 1417293150 | Jodeci Rincon | Dental Assistant | 1330 Shaw Ave Ste 103, Clovis, CA 93612-3985 | 2012-12-28 |
| 1063725364 | Jesse Anthony Padilla | Dental Assistant | 200 W Shaw Ave Ste 110, Clovis, CA 93612-3684 | 2010-07-15 |
| Find all providers in CLOVIS | ||||
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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.