Pelican Point Dental

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

57535 Issued in CA

Legal business name

PELICAN POINT DENTAL

Practice address

31103 Rancho Viejo Road Ste D2444
San Juan Capistrano, CA 92675

Phone

(562) 964-0877

NPI assigned

Apr 17, 2018

Last updated

Apr 17, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Nicole Elizabeth Kuske, DDSNPI 1588805535

Title

Dentist

Phone

(562) 964-0877

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicole Elizabeth Kuske, DDS

  • Dentist
  • Huntington Beach, CA
  • NPI 1588805535
  Authorized official Same address or phone

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

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523923200000",
    "number": "1033606991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31103 RANCHO VIEJO ROAD STE D2444",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "92675",
            "telephone_number": "562-964-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31103 RANCHO VIEJO ROAD STE D2444",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "92675",
            "telephone_number": "562-964-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELICAN POINT DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-17",
        "last_updated": "2018-04-17",
        "status": "A",
        "authorized_official_last_name": "KUSKE",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "562-964-0877",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "57535",
            "primary": false
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "CA",
            "license": "57535",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "57535",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Om R Pathak, DO
• Pathways to Recovery
• Patricia Tay DDS Inc
• Pamela Patterson, CNA, CHHA
• Sarah Elizabeth Pelangka, PH D., BCBA-D, E.S.C
• Andrea Penaloza, AMFT, APCC
• Keith E Penera, D.P.M.
• Pennant Healthcare, Inc.
• Kwitka Durana Peratt, M.D.
• Corinne Marie Perez, NP

• Public Health Dentistry in San Juan Capistrano, CA
• Providers in San Juan Capistrano, CA by specialty
• Public Health Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; 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.