Tracy Nicole DDS a Professional Dental Corporation

Primary specialty

DentistTaxonomy code 122300000X

License

45231 Issued in CA

Legal business name

TRACY NICOLE DDS A PROFESSIONAL DENTAL CORPORATION

Practice address

330 Park Ave
Suite 1
Laguna Beach, CA 92657

Phone

(949) 497-3397

Fax

(949) 497-0227

NPI assigned

Aug 18, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Tracy Nicole, DDSNPI 1356432157

Title

Owner President of Corp

Phone

(949) 497-3397

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tracy Nicole, D.D.S.

  • Dentist
  • Laguna Beach, CA
  • NPI 1356432157
  NPD (past) Authorized official
• Gary Wayne Boling, D.D.S.

  • General Practice Dentistry
  • Alcoa, TN
  • NPI 1487867990
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306950340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 PARK AVE",
            "address_2": "SUITE 1",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "92657",
            "telephone_number": "949-497-3397",
            "fax_number": "949-497-0227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 PARK AVE",
            "address_2": "SUITE 1",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "92657",
            "telephone_number": "949-497-3397",
            "fax_number": "949-497-0227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACY NICOLE DDS A PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NICOLE",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "OWNER PRESIDENT OF CORP",
        "authorized_official_telephone_number": "949-497-3397",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "45231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Akiyah Thurston
• Toan Nguyen Dental Corporation
• Julie Torbensen, LVN
• Ana L. Torres, PA-C
• Roger Townsend, MD
• Courtney Tracy, LCSW, PSYD
• Jennifer Rose Triolo-Legault, DOULA
• Trisha Church License Professional Clinical Counselor
• True Harmony Nutrition LLC
• Raelynn M Tucker, M.D.

• Dentist in Laguna Beach, CA
• Providers in Laguna Beach, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.