Individual provider Active NPI

Jronald Michael Ayzin, DDS

  • General Practice Dentistry
  • Laguna Hills, CA
National Provider Identifier
1104320720
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
102590 Issued in CA
Practice address
24881 Alicia Pkwy Ste H
Laguna Hills, CA 92653-4617
Phone
(949) 707-5273
NPI assigned
Mar 19, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 102590 CA Primary

Addresses

Primary practice location

24881 Alicia Pkwy Ste H
Laguna Hills, CA 92653-4617

Mailing address

7 Faenza
Newport Coast, CA 92657-1602
Phone (949) 400-4720

Other practice location 1

1202 Bristol St Ste 120
Costa Mesa, CA 92626-8606
Phone (714) 540-5511

Other names 1

  • Dr. Ronald Ayzin Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
102590CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Payam C Ataii, DMD, Inc General Practice PastSince Dec 17, 2023 Accepting new patients
Yes Today Dentistry Lewiston PLLC General Practice PastSince May 9, 2021 Accepting new patients
Michael Ayzin DDS Dental Corp Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1104320720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 FAENZA",
            "city": "NEWPORT COAST",
            "state": "CA",
            "postal_code": "926571602",
            "telephone_number": "949-400-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24881 ALICIA PKWY STE H",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926534617",
            "telephone_number": "949-707-5273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1202 Bristol St Ste 120",
            "address_purpose": "LOCATION",
            "city": "Costa Mesa",
            "state": "CA",
            "postal_code": "926268606",
            "country_code": "US",
            "telephone_number": "714-540-5511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AYZIN",
        "first_name": "JRONALD",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-19",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "102590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RONALD",
            "last_name": "AYZIN",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Laguna Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; 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.