Individual provider Active NPI

Anne Ehrenreich Doan Van, D.D.S.

  • Dentist
  • Irvine, CA
National Provider Identifier
1023452364
Registry record updated Apr 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
48449 Issued in CA
Practice address
11 Cedar RDG
Irvine, CA 92603-3610
Phone
(949) 856-3121
NPI assigned
Apr 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 48449 CA Primary

Addresses

Primary practice location

11 Cedar RDG
Irvine, CA 92603-3610

Mailing address

11 Cedar RDG
Irvine, CA 92603-3610
Phone (949) 856-3121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150716003292 CA Order and Referring Only - DentistPractitioner - Dentist 7315250537

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
48449CAMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1366156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366156800000",
    "number": "1023452364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 CEDAR RDG",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926033610",
            "telephone_number": "949-856-3121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 CEDAR RDG",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926033610",
            "telephone_number": "949-856-3121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOAN VAN",
        "first_name": "ANNE",
        "middle_name": "EHRENREICH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-17",
        "last_updated": "2013-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "48449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.