| Western Dental Services, Inc. | |
|
2115 Shattuck Ave Berkeley CA 94704-1208 | |
| (510) 540-8400 | |
| (510) 540-0649 |
| Full Name | Western Dental Services, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2115 Shattuck Ave, Berkeley, California |
| Authorized Official Name and Position | Preet Takkar (CHIEF OPERATIONS 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. 2115 Shattuck Ave Berkeley CA 94704-1208 Ph: (510) 540-8400 |
| NPI Number | 1508920448 |
|---|---|
| Provider Enumeration Date | 12/21/2006 |
| Last Update Date | 12/14/2022 |
| Certification Date | 12/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508920448 | NPI | - | NPPES |
| G90179-67 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (NU) | Primary |
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