Schuppet Dental Corporation

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

54324 Issued in CA

Legal business name

SCHUPPET DENTAL CORPORATION

Practice address

12791 Newport Ave Ste 208
Tustin, CA 92780-8023

Phone

(714) 544-1740

NPI assigned

Mar 30, 2010

Organization subpart

No

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

Authorized official

Name

Henry C Schuppert, D.D.S., M.S.

Title

President

Phone

(949) 863-9620

Specialties & licenses 1

Addresses

Other names 1

• Elite Smiles Doing business as

Locations

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

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269907200000",
    "number": "1104141316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20062 SW BIRCH ST STE 220",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601519",
            "telephone_number": "949-863-9620",
            "fax_number": "949-271-4931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12791 NEWPORT AVE STE 208",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927808023",
            "telephone_number": "714-544-1740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHUPPET DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-30",
        "last_updated": "2010-03-30",
        "status": "A",
        "authorized_official_last_name": "SCHUPPERT",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-863-9620",
        "authorized_official_credential": "D.D.S., M.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "54324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vivian Schrenk, PA
• Julie Elliott Schuck, PH.D.
• Gale J Schuler, PH.D.
• Robert Schuler, MFT
• Christie Lynn Schultz
• Andrea Schwab, DC
• Kimberley R. Argue Schwartz, PHD
• Scott Small, D.O., Inc.
• Katie Miranda Scott, LMFT
• Ramon Scruggs, M.D.

• Orthodontics and Dentofacial Orthopedics Dentistry in Tustin, CA
• Providers in Tustin, 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 Mar 30, 2010; 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.