Active NPI
Jeffrey Charles Sanacore, DDS
- General Practice Dentistry
- Costa Mesa, CA
National Provider Identifier
1114147725
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 40189
- Practice address
- 1525 Mesa Verde Dr E Ste 105
Costa Mesa, CA 92626-5221 - Phone
- (714) 825-0025
- Fax
- (714) 435-0831
- NPI assigned
- Apr 26, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 40189 | CA | Primary |
Addresses
Primary practice location
1525 Mesa Verde Dr E Ste 105
Costa Mesa, CA 92626-5221
Mailing address
1525 Mesa Verde Dr E Ste 105
Costa Mesa, CA 92626-5221
Phone (714) 825-0025
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429574400000",
"number": "1114147725",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1525 MESA VERDE DR E STE 105",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926265221",
"telephone_number": "714-825-0025",
"fax_number": "714-435-0831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1525 MESA VERDE DR E STE 105",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926265221",
"telephone_number": "714-825-0025",
"fax_number": "714-435-0831"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANACORE",
"first_name": "JEFFREY",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-26",
"last_updated": "2015-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "40189",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.