NPIMap

Organization Active NPI

Racho Niguel Dental Group

  • Dentist
  • Laguna Niguel, CA
National Provider Identifier
1396822029
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
37868 Issued in CA
Legal business name
RACHO NIGUEL DENTAL GROUP
Practice address
30140 Town Center Drive
Laguna Niguel, CA 92677
Phone
(949) 249-4180
Fax
(949) 249-4185
NPI assigned
Nov 1, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Gina Rene Martin
Title
Office Manager
Phone
(949) 249-4180

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 37868 CA Primary

Addresses

Primary practice location

30140 Town Center Drive
Laguna Niguel, CA 92677

Mailing address

828 Emerald Bay
Laguna Beach, CA 92651
Phone (949) 249-4180

National Provider Directory

National Provider Directory
Tax ID family
Racho Niguel Dental Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

30140 Town Center Dr
Laguna Niguel, CA 92677
Phone (949) 249-4180

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396822029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "828 EMERALD BAY",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "92651",
            "telephone_number": "949-249-4180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30140 TOWN CENTER DRIVE",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "92677",
            "telephone_number": "949-249-4180",
            "fax_number": "949-249-4185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RACHO NIGUEL DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "RENE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "949-249-4180",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "37868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Niguel, CA

Sources for this page

  • 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.