Organization Active NPI

Nada Traboulsi DDS, Inc.

  • Dentist
  • Brea, CA
National Provider Identifier
1316309990
Registry record updated Mar 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
38377 Issued in CA
Legal business name
NADA TRABOULSI DDS, INC.
Practice address
1220 E Birch St Ste 102
Brea, CA 92821-5155
Phone
(714) 529-4477
NPI assigned
Mar 23, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2016

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

Authorized official

Name
Dr. Nada Traboulsi, DDSNPI 1871703926
Title
Owner
Phone
(714) 529-4477

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 38377 CA Primary

Addresses

Primary practice location

1220 E Birch St Ste 102
Brea, CA 92821-5155

Mailing address

1220 E Birch St Ste 102
Brea, CA 92821-5155

National Provider Directory

National Provider Directory

Locations

1220 E Birch St
Ste 102
Brea, CA 92821
Phone (714) 529-4477

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": "1458691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458691200000",
    "number": "1316309990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 E BIRCH ST STE 102",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928215155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 E BIRCH ST STE 102",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928215155",
            "telephone_number": "714-529-4477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NADA TRABOULSI DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-23",
        "last_updated": "2016-03-23",
        "status": "A",
        "authorized_official_last_name": "TRABOULSI",
        "authorized_official_first_name": "NADA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-529-4477",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "38377",
            "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 23, 2016; 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.