GARY AND MARY WEST SENIOR DENTAL CENTER INC. NPI 1396111530

NPI Information

NPI: 1396111530
Provider Name: GARY AND MARY WEST SENIOR DENTAL CENTER, INC.
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
1525 4TH AVE
SAN DIEGO, CA
ZIP 92101
Phone: (760) 602-5862
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GARY AND MARY WEST SENIOR DENTAL CENTER, INC. is a dental clinic center in San Diego, CA. GARY AND MARY WEST SENIOR DENTAL CENTER, INC. NPI is 1396111530. The provider is registered as an organization entity type.

The provider's business location address is:

1525 4TH AVE
SAN DIEGO, CA
ZIP 92101-107
Phone: (760) 602-5862

The provider's authorized official is Karen Becerra .
The authorized official title is President And Dentist and has the following contact phone number (760) 602-5862.

The enumeration date for this NPI number is 8/11/2015 and was last updated on 8/11/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental	55692	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1740451012	OTHER	CALIFORNIA	INDIVIDUAL DENTAL PROVIDER NPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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