NPIMap

Organization Active NPI

Laguna Beach Dental Excellence

  • Dental Clinic/Center
  • Laguna Beach, CA
National Provider Identifier
1124776604
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
LAGUNA BEACH DENTAL EXCELLENCE
Practice address
330 Park Ave Ste 10
Laguna Beach, CA 92651-2352
Phone
(443) 896-6203
NPI assigned
Mar 14, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Authorized official

Name
Haleh Fazeli, DDSNPI 1841553914
Title
Partner/Owner
Phone
(443) 896-6203

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

330 Park Ave Ste 10
Laguna Beach, CA 92651-2352

Mailing address

330 Park Ave Ste 10
Laguna Beach, CA 92651-2352
Phone (443) 896-6203

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1647216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647475200000",
    "number": "1124776604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 PARK AVE STE 10",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926512352",
            "telephone_number": "443-896-6203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 PARK AVE STE 10",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926512352",
            "telephone_number": "443-896-6203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAGUNA BEACH DENTAL EXCELLENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-14",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A",
        "authorized_official_last_name": "FAZELI",
        "authorized_official_first_name": "HALEH",
        "authorized_official_title_or_position": "PARTNER/OWNER",
        "authorized_official_telephone_number": "443-896-6203",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; 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.