Organization Active NPI

Pankaj Narkhede D D S Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Lake Forest, CA
National Provider Identifier
1174014179
Registry record updated May 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
45155 Issued in CA
Legal business name
PANKAJ NARKHEDE D D S INC
Practice address
24602 Raymond Way Ste L
Lake Forest, CA 92630-4461
Phone
(949) 770-0966
Fax
(949) 770-2899
NPI assigned
May 24, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2018

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

Authorized official

Name
Pankaj Narkhede, DDS
Title
Owner
Phone
(949) 770-0966

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 45155 CA Primary

Addresses

Primary practice location

24602 Raymond Way Ste L
Lake Forest, CA 92630-4461

Mailing address

24602 Raymond Way Ste L
Lake Forest, CA 92630-4461
Phone (949) 770-0966

National Provider Directory

National Provider Directory

Locations

24602 Raymond Way
Ste L
Lake Forest, CA 92630
Phone (949) 770-0966

NPI Registry JSON

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

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527120000000",
    "number": "1174014179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24602 RAYMOND WAY STE L",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926304461",
            "telephone_number": "949-770-0966",
            "fax_number": "949-770-2899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24602 RAYMOND WAY STE L",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926304461",
            "telephone_number": "949-770-0966",
            "fax_number": "949-770-2899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANKAJ NARKHEDE D D S INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-24",
        "last_updated": "2018-05-24",
        "status": "A",
        "authorized_official_last_name": "NARKHEDE",
        "authorized_official_first_name": "PANKAJ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-770-0966",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "45155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2018; 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.