| Western Dental Services, Inc. | |
| 
					1696 W Katella Ave Anaheim CA 92802-3015  | |
| (714) 635-6000 | |
| (714) 635-4319 | 
| Full Name | Western Dental Services, Inc. | 
|---|---|
| Speciality | Dentist - General Practice | 
| Location | 1696 W Katella Ave, Anaheim, California | 
| Authorized Official Name and Position | Preet Takkar (CHIEF INFORMATION OFFICER) | 
| Authorized Official Contact | 7145713372 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Western Dental Services, Inc. 530 S Main St Orange CA 92868-4525 Ph: (714) 480-3000  | Western Dental Services, Inc. 1696 W Katella Ave Anaheim CA 92802-3015 Ph: (714) 635-6000  | 
| NPI Number | 1114089638 | 
|---|---|
| Provider Enumeration Date | 12/14/2006 | 
| Last Update Date | 03/11/2019 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1114089638 | NPI | - | NPPES | 
| G90179-05 | Medicaid | CA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary | 
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