WILMINGTON DENTAL GROUP
NPI 1649656489
Dentist in Wilmington, CA

NPI Status: Active since August 04, 2015

Contact Information

414 W PACIFIC COAST HWY
WILMINGTON, CA
ZIP 90744
Phone: (310) 518-3522

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  • Organization
  • Dentist
  • CLIA Number: 05D0951358
  • CLIA Cert. Type: Community Clinic
  • CLIA Exp. Date: 08-05-2026

About WILMINGTON DENTAL GROUP

This page provides the complete NPI Profile along with additional information for Wilmington Dental Group, a provider established in Wilmington, California operating as a Dentist. The healthcare provider is registered in the NPI registry with number 1649656489 assigned on August 2015. The practitioner's primary taxonomy code is 122300000X with license number 61918 (CA). The provider is registered as an organization and their NPI record was last updated 11 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is John Yoo (Owner)

NPI
1649656489
Provider Name
WILMINGTON DENTAL GROUP
Entity Type
Organization
Location Address
414 W PACIFIC COAST HWY WILMINGTON, CA 90744
Location Phone
(310) 518-3522
Mailing Address
414 W PACIFIC COAST HWY WILMINGTON, CA 90744
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
08-04-2015
Last Update Date
08-04-2015
Code Navigator

A dentist like Wilmington Dental Group is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dentist

Taxonomy Code
122300000X
Type
Dental Providers
License No.
61918
License State
CA
Taxonomy Description
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1122300000XDental Providers

Dentist

61938 (CA)

Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JOHN YOO

Authorized Official Title
OWNER
Authorized Official Phone
(310) 518-3522

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D0951358
Facility Type
Community Clinic
Certificate Effective Date
August 06, 2024
Certificate Expiration Date
August 05, 2026
Laboratory Director
JEFFREY T. BARBOSA MD
Certificate Type
Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description
This CLIA certificate is issued to Wilmington Dental Group in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1649656489, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 71. The final step is to find the difference between that total and the next multiple of ten (80 - 71 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
4
Doubled → 8
Pos 4
9
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
5
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
4
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
9
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 6 → 12 → 3 6 → 12 → 3 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 8 + 9 + 1 + 2 + 5 + 1 + 2 + 4 + 1 + 6 + 24 = 71

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 71 is 80. The difference is the calculated check digit.

80 - 71 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1649656489.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Dentist (General Practice)
414 W PACIFIC COAST HWY
WILMINGTON, CA 90744
Dentist (General Practice)
414 W PACIFIC COAST HWY
WILMINGTON, CA 90744

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1649656489, enumerated as an "organization" on August 04, 2015.

The provider is located at 414 W PACIFIC COAST HWY WILMINGTON, CA 90744 and the phone number is (310) 518-3522.

Dentist with taxonomy code 122300000X.