Premier Pediatric Dentistry Inc

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

PREMIER PEDIATRIC DENTISTRY INC

Practice address

24541 Pacific Park Dr Ste 240
Aliso Viejo, CA 92656-3050

Phone

(949) 880-6683

NPI assigned

Nov 5, 2024

Last updated

Nov 5, 2024By 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

Daggiana L Corgnell

Title

Office Manager

Phone

(949) 880-6683

Specialties & licenses 1

Addresses

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.

• Ivan W. Ho, D.D.S.

  • General Practice Dentistry
  • Laguna Hills, CA
  • NPI 1891762886
  NPD

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730764800000",
    "number": "1033932363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24541 PACIFIC PARK DR STE 240",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926563050",
            "telephone_number": "949-880-6683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24541 PACIFIC PARK DR STE 240",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926563050",
            "telephone_number": "949-880-6683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PEDIATRIC DENTISTRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-04",
        "status": "A",
        "authorized_official_last_name": "CORGNELL",
        "authorized_official_first_name": "DAGGIANA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "949-880-6683"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gisella Xianne Plaza, RPT
• Linda Diane Pongracz, LVN
• Roni Portillo, MFTI
• Ariana Pourbabak, PHARMD
• Premier Dental of South Orange County
• Kristina Louise Preston, PA-C
• Melissa Prickett, O.D.
• Prism Health Inc. (Aliso Laguna Villa)
• Private Hospitalist Medical Group
• Cristalle Pronier, CMT

• Pediatric Dentistry in Aliso Viejo, CA
• Providers in Aliso Viejo, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.