Guadalupe a. Mejia Dental Corp.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS100192 Issued in CA

Legal business name

GUADALUPE A. MEJIA DENTAL CORP.

Doing business as

Millennium Dental

Practice address

700 W 19TH St.
Suite C
Costa Mesa, CA 92627

Phone

(949) 722-9027

NPI assigned

Jun 21, 2017

Last updated

Jun 21, 2017By the provider in NPPES

Organization subpart

Yes

Parent organization

GUADALUPE A. MEJIA DENTAL CORP.As reported in NPPES

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

Authorized official

Name

Guadalupe Ana Mejia, DDS

Title

President

Phone

(714) 553-0751

Specialties & licenses 1

Addresses

Other names 1

• Millennium Dental Doing business as

Part of

Guadalupe a Mejia Dental Corp

Locations

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498003200000",
    "number": "1366962334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W 19TH ST.",
            "address_2": "SUITE C",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "92627",
            "telephone_number": "949-722-9027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W 19TH ST.",
            "address_2": "SUITE C",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "92627",
            "telephone_number": "949-722-9027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUADALUPE A. MEJIA DENTAL CORP.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GUADALUPE A. MEJIA DENTAL CORP.",
        "enumeration_date": "2017-06-21",
        "last_updated": "2017-06-21",
        "status": "A",
        "authorized_official_last_name": "MEJIA",
        "authorized_official_first_name": "GUADALUPE",
        "authorized_official_middle_name": "ANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-553-0751",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS100192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Millennium Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kaitlyn M Gross
• Jamie Grossman
• Kaytee Groves
• Tierra Ilicia Leigh Grubbs, ABOC, FNAO
• Holly Copsey Gruber, M.P.T.
• Ashley Belen Guanilo
• Guardian Health Care Services (D'Amore Healthcare)
• Guardian Health Care Services (D'Amore Healthcare)
• Guardian Healthcare Services (D'Amore Healthcare)
• John Paul Guarnes

• General Practice Dentistry in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2017; 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.