Jack George, D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

19885 Issued in CA

Practice address

31441 Santa Margarita Pkwy
Suite G
Rancho Santa Margarita, CA 92688-1836

Phone

(949) 589-7820

Fax

(949) 589-2301

NPI assigned

Mar 21, 2007

Reactivated

Sep 11, 2013

Last updated

Sep 11, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378857600000",
    "number": "1033235023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31441 SANTA MARGARITA PKWY",
            "address_2": "SUITE G",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926881836",
            "telephone_number": "949-589-7820",
            "fax_number": "949-589-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31441 SANTA MARGARITA PKWY",
            "address_2": "SUITE G",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926881836",
            "telephone_number": "949-589-7820",
            "fax_number": "949-589-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2013-09-11",
        "deactivation_date": "2009-03-11",
        "reactivation_date": "2013-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "19885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Rancho Santa Margarita, CA
• Providers in Rancho Santa Margarita, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.