Organization Active NPI

Orange County Ear, Nose & Throat

  • Specialist
  • Irvine, CA
National Provider Identifier
1205924511
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
ORANGE COUNTY EAR, NOSE & THROAT
Practice address
22 Odyssey Ste 100
Irvine, CA 92618-3186
Phone
(949) 679-9000
Fax
(949) 679-9001
NPI assigned
Oct 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2022

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

Authorized official

Name
Mrs. Michelle Crystal Dena
Title
Office Manager
Phone
(949) 305-8252

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X CA Primary

Addresses

Primary practice location

22 Odyssey Ste 100
Irvine, CA 92618-3186

Mailing address

24411 Health Center Drive
Suite 600
Laguna Hills, CA 92653
Phone (949) 305-8000

Other practice location 1

24411 Health Center Dr Ste 600
Laguna Hills, CA 92653-3687
Phone (949) 305-8000

Other names 1

  • ENTA Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100407000191 CA Part B Supplier - Clinic/Group Practice 9537295167 Receives reassigned benefits from 3 practitioners
Practice locations: Irvine, CA; Laguna Hills, CA

National Provider Directory

National Provider Directory

Locations

24411 Health Center Dr
Ste 600
Laguna Hills, CA 92653
Phone (949) 305-8000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 3

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": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663804800000",
    "number": "1205924511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24411 HEALTH CENTER DRIVE",
            "address_2": "SUITE 600",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "92653",
            "telephone_number": "949-305-8000",
            "fax_number": "949-305-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 ODYSSEY STE 100",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183186",
            "telephone_number": "949-679-9000",
            "fax_number": "949-679-9001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24411 Health Center Dr Ste 600",
            "address_purpose": "LOCATION",
            "city": "Laguna Hills",
            "state": "CA",
            "postal_code": "926533687",
            "country_code": "US",
            "telephone_number": "949-305-8000",
            "fax_number": "949-305-8001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ORANGE COUNTY EAR, NOSE & THROAT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A",
        "authorized_official_last_name": "DENA",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "CRYSTAL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "949-305-8252",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ENTA",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "ENTA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.