Mission Viejo Dental Associates

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

20049 Issued in CA

Legal business name

MISSION VIEJO DENTAL ASSOCIATES

Practice address

25522 Marguerite Parkway
#100
Mission Viejo, CA 92692

Phone

(949) 586-6200

Fax

(949) 586-2791

NPI assigned

May 29, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Robert W Stalcup, DDS

Title

Owner

Phone

(949) 586-6200

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Kristen Le Tran, DDS

  • Dentist
  • Mission Viejo, CA
  • NPI 1376085720
  NPD (past)

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212019200000",
    "number": "1063670768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25522 MARGUERITE PKWY",
            "address_2": "#100",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "92692",
            "telephone_number": "949-586-6200",
            "fax_number": "949-586-2791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25522 MARGUERITE PARKWAY",
            "address_2": "#100",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "92692",
            "telephone_number": "949-586-6200",
            "fax_number": "949-586-2791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION VIEJO DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-29",
        "last_updated": "2008-05-29",
        "status": "A",
        "authorized_official_last_name": "STALCUP",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-586-6200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "20049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mission Pediatric Med CL
• Mission Pediatric Medical Clinic, Inc.
• Mission Toxicology, LLC
• Mission Trauma Surgical Medical GRP
• Mission Viejo Assisted Living LLC
• Mission Viejo Emergency Medical Associates
• Mission Viejo Endoscopy Partners, LLC
• Mission Viejo Family Medical Center
• Mission Viejo Modern Dentistry, Prof. Corp.
• Mission Viejo Office

• Dental Clinic/Center in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; 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.