Individual provider Active NPI

Dina Mustafa Alshunnaq, M.D.

  • Pediatrics Physician
  • Mission Viejo, CA
National Provider Identifier
1265745756
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
C167801 Issued in CA
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

Updated by the provider on Oct 7, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
C167801CAMDPediatrics Physician
46105KYMDPediatrics Physician
56174TNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew 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

  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.