NPIMap

Organization Active NPI

Irvine Pediatric Dentistry & Orthodontics

  • Pediatric Dentistry
  • Irvine, CA
National Provider Identifier
1043330152
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
15673 Issued in CA
Legal business name
IRVINE PEDIATRIC DENTISTRY & ORTHODONTICS
Practice address
4902 Irvine Center Dr
Suite 111
Irvine, CA 92604-3305
Phone
(949) 559-0674
Fax
(949) 559-7909
NPI assigned
Mar 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. David Bergeman Haag, D.D.S.
Title
Partner
Phone
(949) 559-0674

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 15673 CA Primary

Addresses

Primary practice location

4902 Irvine Center Dr
Suite 111
Irvine, CA 92604-3305

Mailing address

4902 Irvine Center Dr
Suite 111
Irvine, CA 92604-3305
Phone (949) 559-0674

Other names 1

  • IPDO Other name

National Provider Directory

National Provider Directory

Locations

4902 Irvine Center Dr
Ste 111
Irvine, CA 92604
Phone (949) 559-0674

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043330152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4902 IRVINE CENTER DR",
            "address_2": "SUITE 111",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926043305",
            "telephone_number": "949-559-0674",
            "fax_number": "949-559-7909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4902 IRVINE CENTER DR",
            "address_2": "SUITE 111",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926043305",
            "telephone_number": "949-559-0674",
            "fax_number": "949-559-7909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRVINE PEDIATRIC DENTISTRY & ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAAG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "BERGEMAN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "949-559-0674",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "15673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IPDO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.