Active NPI
Dina Mustafa Alshunnaq, M.D.
- Pediatrics Physician
- Mission Viejo, CA
National Provider Identifier
1265745756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- C167801
- Practice address
- 26161 La Paz Rd Ste 115
Mission Viejo, CA 92691-5334 - Phone
- (949) 206-0001
- Fax
- (949) 206-0011
- NPI assigned
- Jul 26, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 56174 | TN | |
| Pediatrics Physician | 208000000X | C167801 | CA | Primary |
| Pediatrics Physician | 208000000X | 46105 | KY |
Addresses
Primary practice location
26161 La Paz Rd Ste 115
Mission Viejo, CA 92691-5334
Mailing address
26161 La Paz Rd Ste 115
Mission Viejo, CA 92691-5334
Phone (949) 206-0001
Other practice location 1
214 Hospital Rd
Pediatric Clinic
Whitesburg, KY 41858-7627
Phone (606) 633-4414
Other practice location 2
325 N. State of Franklin Road, Ground Floor
Johnson City, TN 37604-6062
Phone (423) 439-7320
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
| License | State | Type | Specialty |
|---|---|---|---|
| C167801 | CA | MD | Pediatrics Physician |
| 46105 | KY | MD | Pediatrics Physician |
| 56174 | TN | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Appalachian Regional Healthcare, Inc. | Past | Accepting new patients | |
| Mountain States Health Alliance | Past | Accepting new patients | |
| Mia Bella Pediatrics | Pediatrics | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- dalshunnaq666418@direct.memorialcare.org
Organizations & group practices 3
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.
-
- Pediatrics Physician
- Mission Viejo, CA
- NPI 1841492840
-
- General Acute Care Hospital
- Whitesburg, KY
- NPI 1194723726
-
- General Acute Care Hospital
- Johnson City, TN
- NPI 1972606465
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602028800000",
"number": "1265745756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26161 LA PAZ RD STE 115",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "926915334",
"telephone_number": "949-206-0001",
"fax_number": "949-206-0011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26161 LA PAZ RD STE 115",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "926915334",
"telephone_number": "949-206-0001",
"fax_number": "949-206-0011"
}
],
"practiceLocations": [
{
"address_1": "214 Hospital Rd",
"address_2": "Pediatric Clinic",
"address_purpose": "LOCATION",
"city": "Whitesburg",
"state": "KY",
"postal_code": "418587627",
"country_code": "US",
"telephone_number": "606-633-4414",
"fax_number": "606-633-3652",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "325 N. State of Franklin Road, Ground Floor",
"address_purpose": "LOCATION",
"city": "Johnson City",
"state": "TN",
"postal_code": "376046062",
"country_code": "US",
"telephone_number": "423-439-7320",
"fax_number": "423-439-7343",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ALSHUNNAQ",
"first_name": "DINA",
"middle_name": "MUSTAFA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-26",
"last_updated": "2020-10-07",
"certification_date": "2020-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TN",
"license": "56174",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "C167801",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "KY",
"license": "46105",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mission Viejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.