Organization Active NPI

SCDP Laguna Hills

  • General Practice Dentistry
  • Laguna Hills, CA
National Provider Identifier
1306420526
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SCDP LAGUNA HILLS
Practice address
24741 Alicia Pkwy Ste a
Laguna Hills, CA 92653-4613
Phone
(949) 855-0450
NPI assigned
May 12, 2021
Organization subpart
Yes
Parent organization
SILVER CREEK DENTAL PARTNERS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Authorized official

Name
Brad Starkweather
Title
Manager
Phone
(650) 922-0897

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

24741 Alicia Pkwy Ste a
Laguna Hills, CA 92653-4613

Mailing address

23911 Danzig Bay
Dana Point, CA 92629-4407
Phone (650) 922-0897

Other names 1

  • Laguna Hills Dental Doing business as

National Provider Directory

National Provider Directory
Part of
Silver Creek Dental Partners

Locations

24741 Alicia Pkwy
Ste A
Laguna Hills, CA 92653
Phone (949) 855-0450

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

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": "1620777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620777600000",
    "number": "1306420526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23911 DANZIG BAY",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926294407",
            "telephone_number": "650-922-0897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24741 ALICIA PKWY STE A",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926534613",
            "telephone_number": "949-855-0450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCDP LAGUNA HILLS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SILVER CREEK DENTAL PARTNERS, LLC",
        "enumeration_date": "2021-05-12",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A",
        "authorized_official_last_name": "STARKWEATHER",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "650-922-0897"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laguna Hills Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laguna Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; 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.