Brooke Ashley Pancer, DMD, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

102455 Issued in CA

Practice address

2999 Westminster Blvd Seal Beach Dental Implants
Seal Beach, CA 90740

Phone

(562) 431-9739

Fax

(734) 763-5503

NPI assigned

Feb 8, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1144592064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 SAN JOAQUIN PLAZA",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92660",
            "telephone_number": "734-763-3389",
            "fax_number": "734-763-5503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2999 WESTMINSTER BLVD SEAL BEACH DENTAL IMPLANTS",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "90740",
            "telephone_number": "562-431-9739",
            "fax_number": "734-763-5503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANCER",
        "first_name": "BROOKE",
        "middle_name": "ASHLEY",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-08",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "102455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn Ozimok, LMFT
• Pacific Coast Health Medical Group a Professional Corporation
• Steven Palacios
• Marlyn Palmquist
• Leticia Palos-Rafuse, BCBA
• Ourania Zoie Papantoniadis, PA-C
• Joshua David Paredes, D.C.
• David Rae Park, MD
• Tracee Parker, PH.D.
• Bharti V Pathak, PHARM.D.

• Periodontics in Seal Beach, CA
• Providers in Seal Beach, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.