Individual provider Active NPI

Nelson Pai, DDS

  • General Practice Dentistry
  • Los Alamitos, CA
National Provider Identifier
1104967959
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
34540 Issued in CA
Practice address
5122 Katella Ave
Suite 112
Los Alamitos, CA 90720-2826
Phone
(562) 493-2807
Fax
(562) 598-3332
NPI assigned
Feb 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 34540 CA Primary

Addresses

Primary practice location

5122 Katella Ave
Suite 112
Los Alamitos, CA 90720-2826

Mailing address

5122 Katella Ave
Suite 112
Los Alamitos, CA 90720-2826
Phone (562) 493-2807

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150720001049 CA Order and Referring Only - DentistPractitioner - Dentist 7517270655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nelson Pai DDS & Susan Ishioka DDS Ms, Inc. General Practice Past Accepting new patients

Organizations & group practices 1

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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104967959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5122 KATELLA AVE",
            "address_2": "SUITE 112",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202826",
            "telephone_number": "562-493-2807",
            "fax_number": "562-598-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5122 KATELLA AVE",
            "address_2": "SUITE 112",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202826",
            "telephone_number": "562-493-2807",
            "fax_number": "562-598-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAI",
        "first_name": "NELSON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "34540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamitos, CA

Sources for this page

Verify at the official NPI Registry.