Provider Demographics
NPI:1881850972
Name:WILLIAM N. LANGSTAFF, D.M.D.
Entity type:Organization
Organization Name:WILLIAM N. LANGSTAFF, D.M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:RACHEL
Authorized Official - Last Name:LANGSTAFF
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:714-637-9270
Mailing Address - Street 1:17871 SANTIAGO BLVD
Mailing Address - Street 2:SUITE 228
Mailing Address - City:VILLA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:92861-4141
Mailing Address - Country:US
Mailing Address - Phone:714-637-9270
Mailing Address - Fax:714-637-2782
Practice Address - Street 1:17871 SANTIAGO BLVD
Practice Address - Street 2:SUITE 228
Practice Address - City:VILLA PARK
Practice Address - State:CA
Practice Address - Zip Code:92861-4141
Practice Address - Country:US
Practice Address - Phone:714-637-9270
Practice Address - Fax:714-637-2782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-29
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23338332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6353740001Medicare NSC