Healthcare Provider Details

I. General information

NPI: 1558293183
Provider Name (Legal Business Name): WEBB AVE DENTISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2420 WEBB AVE
ALAMEDA CA
94501-2923
US

IV. Provider business mailing address

2420 WEBB AVE
ALAMEDA CA
94501-2923
US

V. Phone/Fax

Practice location:
  • Phone: 510-521-9800
  • Fax: 510-521-1862
Mailing address:
  • Phone: 510-521-9800
  • Fax: 510-521-1862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: KAREN N LARSON
Title or Position: OWNER
Credential:
Phone: 510-521-9800