JACK ELLIOT WASSERSTEIN DDS NPI 1548574767

NPI Information

  • NPI: 1548574767
  • Provider Name: JACK ELLIOT WASSERSTEIN, DDS
  • Classification: Dentist - 1223P0300X
  • Specialization: Periodontics
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 27450 TOURNEY RD
    SUITE 100
    VALENCIA, CA
    ZIP 91355
  • Phone: (661) 254-8484

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NPI Details

Jack Elliot Wasserstein, DDS is a periodontics dentist in Valencia, CA. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. Jack Elliot Wasserstein, DDS NPI is 1548574767. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

27450 TOURNEY RD
SUITE 100
VALENCIA, CA
ZIP 91355-828
Phone: (661) 254-8484
Fax: (661) 254-8669

The NPI 1548574767 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 7/29/2010 and was last updated on 7/29/2010.

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
11223P0300XDentistPeriodontics36297CALIFORNIAYes

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: 11/21/2025

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