NPIMap

Organization Active NPI

Premier Dental of South Orange County

  • Dental Clinic/Center
  • Aliso Viejo, CA
National Provider Identifier
1386296952
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
PREMIER DENTAL OF SOUTH ORANGE COUNTY
Practice address
24541 Pacific Park Dr Ste 240
Aliso Viejo, CA 92656-3050
Phone
(949) 831-0051
Fax
(949) 831-0037
NPI assigned
Jul 12, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2019

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

Authorized official

Name
Mrs. Marian S Bradford, DDSNPI 1902008659
Title
Dentist/Owner
Phone
(949) 831-0051

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
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

24541 Pacific Park Dr Ste 240
Aliso Viejo, CA 92656-3050

Mailing address

24541 Pacific Park Dr Ste 240
Aliso Viejo, CA 92656-3050
Phone (949) 831-0051

National Provider Directory

National Provider Directory

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": "1562889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562889600000",
    "number": "1386296952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24541 PACIFIC PARK DR STE 240",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926563050",
            "telephone_number": "949-831-0051",
            "fax_number": "949-831-0037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24541 PACIFIC PARK DR STE 240",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926563050",
            "telephone_number": "949-831-0051",
            "fax_number": "949-831-0037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER DENTAL OF SOUTH ORANGE COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-12",
        "last_updated": "2019-07-12",
        "status": "A",
        "authorized_official_last_name": "BRADFORD",
        "authorized_official_first_name": "MARIAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "949-831-0051",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aliso Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; 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.