Individual provider Active NPI

Max Dow Swancutt Jr., D.D.S.

  • Dentist
  • Newport Beach, CA
National Provider Identifier
1164446696
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
26708 Issued in CA
Practice address
1901 Westcliff Dr
Suite 4
Newport Beach, CA 92660-5598
Phone
(949) 646-1120
Fax
(949) 646-1150
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
Yes

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
Dentist 122300000X 26708 CA Primary

Addresses

Primary practice location

1901 Westcliff Dr
Suite 4
Newport Beach, CA 92660-5598

Mailing address

1901 Westcliff Dr
Suite 4
Newport Beach, CA 92660-5598
Phone (949) 646-1120

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
26708CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164446696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 WESTCLIFF DR",
            "address_2": "SUITE 4",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926605598",
            "telephone_number": "949-646-1120",
            "fax_number": "949-646-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 WESTCLIFF DR",
            "address_2": "SUITE 4",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926605598",
            "telephone_number": "949-646-1120",
            "fax_number": "949-646-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANCUTT",
        "first_name": "MAX",
        "middle_name": "DOW",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "26708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.