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CLINTON KEITH DENTAL GROUP
NPI 1457445231
Dentist - General Practice in Wildomar, CA

Active since October 03, 2006CLIA 05D2345809 · Waiver
23905 CLINTON KEITH RD, STE. 108, WILDOMAR, CA 92595(951) 304-9700(951) 304-9711 Get Directions Write a Review

NPPES record last updated: July 2, 2012. Verified against the NPPES registry weekly; last sync: September 13, 2026.

About Clinton Keith Dental Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLINTON KEITH DENTAL GROUP (NPI 1457445231) is a healthcare organization registered as a general practice in Wildomar, California and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through June 16, 2028 and lists Bryan K Watanabe, Owner Dds, as its authorized official.

NPPES Registry Identity

NPI1457445231
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameDIANA DO-YABUT AND BRYAN WATANABE DENTAL CORPORATION
Location Address23905 CLINTON KEITH RD, STE. 108Wildomar, CA 92595-7897
Mailing Address2860 Michelle Drive, 2nd FloorIrvine, CA 92606-1009 · (714) 368-2077 · Fax (714) 368-2092
Phone(951) 304-9700
Fax(951) 304-9711
Organization SubpartNo
Authorized OfficialBryan K WatanabeOwner Dds · (951) 304-9700
Enumeration DateOctober 3, 2006
Last NPPES UpdateJuly 2, 2012
✔ NPI 1457445231 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Licenses✔ Licensed in CA · 40130✔ Licensed in CA · 49784
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Also ListedDentist · PeriodonticsTaxonomy 1223P0300X · License 37772 (CA)
Also ListedDentist · Oral and Maxillofacial SurgeryTaxonomy 1223S0112X · License 50080 (CA)
23905 CLINTON KEITH RD, Wildomar, CA 92595
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Other Names 1

Doing Business AsClinton Keith Dental Group

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2345809

Clinton Keith Dental Group · Wildomar, CA
Active · expires Jun 16, 2028
CLIA Number05D2345809
Laboratory TypePractitioner Other
Certificate Effective DateJune 17, 2026
Certificate Expiration DateJune 16, 2028
Laboratory DirectorMinh D. Tran
Laboratory Phone(951) 304-9700
Laboratory LocationClinton Keith Dental Group23905 Clinton Keith Rd, Ste 108, Wildomar, CA 92595
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ISAIAH ABDELMESEEH DDS
Dentist (General Practice)
23905 CLINTON KEITH RD
WILDOMAR, CA 92595
Riverside County (951) 741-3673
CHARITY MORRIS YOON
Physician Assistant
23905 CLINTON KEITH RD, #114
WILDOMAR, CA 92595
Riverside County (951) 672-7673
CAROL JOY COLE LCSW
Social Worker
23905 CLINTON KEITH RD, 114-196
WILDOMAR, CA 92595
Riverside County (951) 677-2806
DR. CHRISTIAN JOHN ROESSLER DMD
Dentist (General Practice)
23905 CLINTON KEITH RD
WILDOMAR, CA 92595
Riverside County (951) 304-9700
DR. SAIED SAMUEL AHDOUT DMD
Dentist (Periodontics)
23905 CLINTON KEITH RD, STE. 108
WILDOMAR, CA 92595
Riverside County (951) 304-9700
MARK A JURY, OD A OPTOMETRIC PROFESSIONAL CORPORATION
Optometrist
23905 CLINTON KEITH RD, STE #115
WILDOMAR, CA 92595
Riverside County (951) 304-9733
MARK ALAN JURY OD
Optometrist
23905 CLINTON KEITH RD, SUITE115
WILDOMAR, CA 92595
Riverside County (951) 304-9733
DR. BRIAN LEMOYNE PARKER O.D.
Optometrist
23905 CLINTON KEITH RD, STE 115
WILDOMAR, CA 92595
Riverside County (951) 304-9733

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Diana Do-Yabut And Bryan Watanabe Dental Corporation's NPI number?

The NPI number for Diana Do-Yabut And Bryan Watanabe Dental Corporation is 1457445231. It was assigned to this organization in the NPPES registry on October 3, 2006. The provider is doing business as Clinton Keith Dental Group.

Where is Diana Do-Yabut And Bryan Watanabe Dental Corporation located?

Diana Do-Yabut And Bryan Watanabe Dental Corporation is located at 23905 Clinton Keith Rd Ste. 108, Wildomar, CA 92595. The listed phone number is (951) 304-9700.

What is Diana Do-Yabut And Bryan Watanabe Dental Corporation's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Does Diana Do-Yabut And Bryan Watanabe Dental Corporation hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2345809) is associated with this NPI, valid through June 16, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Diana Do-Yabut And Bryan Watanabe Dental Corporation was last updated on July 2, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.