# DAVID R. WYNDHAMSMITH, A PROFESSIONAL DENTAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pasadena Medical/Dental Specialist
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508088675
- **Authorized official:** MRS. PATRICE A WYNDHAMSMITH (OFFICE MANAGER)
- **Authorized official phone:** (626) 795-9328

## Contact information

- **Practice address:** 1092 E GREEN ST, PASADENA, CA 91106-2506
- **Practice address phone:** (626) 395-5140
- **Practice address fax:** (626) 395-5144
- **Mailing address:** 1092 E GREEN ST, PASADENA, CA 91106-2506
- **Mailing address phone:** (626) 395-5140
- **Mailing address fax:** (626) 395-5144

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 46195 | CA | Yes |
| 1223P0300X | Periodontics | 41122 | CA | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 49312 | CA | — |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | 37519 | CA | — |

## Other

- **Enumeration date:** 05/02/2007
- **Last updated:** 10/15/2015