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Contact Information

DAVID R. WYNDHAMSMITH, A PROFESSIONAL DENTAL CORPORATION
1092 E GREEN ST
PASADENA, CA91106-2506
 Phone: 626-395-5140
 Fax: 626-395-5144
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Endodontics

1223E0200X
 

Oral and Maxillofacial Surgery

1223S0112X 19 Oral Surgery (Dentist only)
 

Orthodontics and Dentofacial Orthopedics

1223X0400X
 

Periodontics

1223P0300X
Indicates primary specialty

NPI Profile & details for DAVID R. WYNDHAMSMITH, A PROFESSIONAL DENTAL CORPORATION

NPI Number 1508088675
LBN Legal business name DAVID R. WYNDHAMSMITH, A PROFESSIONAL DENTAL CORPORATION
Authorized official PATRICE WYNDHAMSMITH - (OFFICE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/02/2007
Last updated 10/15/2015 - About 11 years ago
Identifiers
CA License # 37519
CA License # 41122
CA License # 46195
CA License # 49312
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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