Individual provider Active NPI

Lena S Debaz, DMD

  • General Practice Dentistry
  • Brea, CA
National Provider Identifier
1255757647
Registry record updated Mar 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
100403 Issued in CA
Practice address
307 N Brea Blvd
Brea, CA 92821-4053
Phone
(714) 594-7009
NPI assigned
Mar 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2019

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 100403 CA Primary

Addresses

Primary practice location

307 N Brea Blvd
Brea, CA 92821-4053

Mailing address

1260 N Hancock St Ste 102
Anaheim, CA 92807-1951
Phone (440) 554-1475

Other practice location 1

16111 Plummer St
Sepulveda, CA 91343-2036
Phone (818) 891-7711

Other practice location 2

16111 Plummer St
Sepulveda, CA 91343-2036
Phone (818) 891-7711

Other practice location 3

2500 E Imperial Hwy Ste 120
Brea, CA 92821-6116
Phone (440) 554-1475

Other practice location 4

13139 Central Ave
Chino, CA 91710
Phone (440) 554-1475

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
100403CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
John Y Chung DMD Inc General Practice CurrentSince Apr 23, 2023 Accepting new patients

Locations

307 N Brea Blvd
Brea, CA 92821
Phone (714) 594-7009

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": "1394409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1255757647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 N HANCOCK ST STE 102",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928071951",
            "telephone_number": "440-554-1475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 N BREA BLVD",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928214053",
            "telephone_number": "714-594-7009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16111 Plummer St",
            "address_purpose": "LOCATION",
            "city": "Sepulveda",
            "state": "CA",
            "postal_code": "913432036",
            "country_code": "US",
            "telephone_number": "818-891-7711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16111 Plummer St",
            "address_purpose": "LOCATION",
            "city": "Sepulveda",
            "state": "CA",
            "postal_code": "913432036",
            "country_code": "US",
            "telephone_number": "818-891-7711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 E Imperial Hwy Ste 120",
            "address_purpose": "LOCATION",
            "city": "Brea",
            "state": "CA",
            "postal_code": "928216116",
            "country_code": "US",
            "telephone_number": "440-554-1475",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13139 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Chino",
            "state": "CA",
            "postal_code": "91710",
            "country_code": "US",
            "telephone_number": "440-554-1475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEBAZ",
        "first_name": "LENA",
        "middle_name": "S",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-10",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "100403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brea, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; 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.