Individual provider Active NPI

Gregory Allen Mohr, D.D.S.

  • General Practice Dentistry
  • Placentia, CA
National Provider Identifier
1205053238
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
032367 Issued in CA
Practice address
1251 E Imperial Hwy
Placentia, CA 92870-1718
Phone
(714) 528-8292
Fax
(714) 528-8373
NPI assigned
Apr 19, 2007
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
General Practice Dentistry 1223G0001X 032367 CA Primary

Addresses

Primary practice location

1251 E Imperial Hwy
Placentia, CA 92870-1718

Mailing address

1251 E Imperial Hwy
Placentia, CA 92870-1718
Phone (714) 528-8292

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230120001589 CA Order and Referring Only - DentistPractitioner - Dentist 4587035027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
032367CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Van T. Nguyen DMD Corp PastSince Oct 31, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205053238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 E IMPERIAL HWY",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928701718",
            "telephone_number": "714-528-8292",
            "fax_number": "714-528-8373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 E IMPERIAL HWY",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928701718",
            "telephone_number": "714-528-8292",
            "fax_number": "714-528-8373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHR",
        "first_name": "GREGORY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "032367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placentia, CA

Sources for this page

Verify at the official NPI Registry.