MEDICARE: WESTERN DENTAL SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710030879
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTERN DENTAL SERVICES, INC.

Provider Business Mailing Address
First Line	:	530 S MAIN ST
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92868-4525
Country	:	US
Telephone Number	:	714-480-3000
Fax Number	:	714-571-3560

Provider Business Practice Location Address
First Line	:	1871 CAMDEN AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95124-2945
Country	:	US
Telephone Number	:	408-377-5700
Fax Number	:	408-377-0592

Authorized Official
Title or Position	:	PPO COORDINATOR
Name	:	MRS. MARINA KING
Credential	:
Telephone Number	:	714-480-3000

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	08/22/2020

Similar Medicare Providers

1881914000 — GRUPO MEDICO POLICLINICA SAN PEDRO MEDICARE ADVANTAGE
Practice Location Address:

211 CALLE MORSE
ARROYO, PR
00714-2350

Practice Phone: 787-839-3980
Practice Fax: 787-271-2515

1497815732 — DR. KEVIN SOLTANI D.D.S.
Practice Location Address:

1871 CAMDEN AVE , WESTERN DENTAL CENTERS
SAN JOSE, CA
95124-2945

Practice Phone: 408-377-0131
Practice Fax: 408-377-0592

1962563122 — DR. SONU MADAN DDS
Practice Location Address:

1871 CAMDEN AVE
SAN JOSE, CA
95124-2945

Practice Phone: 408-377-5700
Practice Fax:

1477939023 — DR. AMY SIU-YIN TAM DDS
Practice Location Address:

1871 CAMDEN AVE
SAN JOSE, CA
95124-2945

Practice Phone: 408-796-3109
Practice Fax:

1427182179 — ANDREW D HARSANY DDS INC
Practice Location Address:

2945 THE VILLAGES PARKWAY
SAN JOSE, CA
95135

Practice Phone: 408-270-9450
Practice Fax: 408-270-9455

1750668182 — CAT-MINH NGO
Practice Location Address:

2945 MACINTYRE DR APT 105
SAN JOSE, CA
95136-1200

Practice Phone: 408-768-7826
Practice Fax:

Directions to “WESTERN DENTAL SERVICES, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.