Individual provider Active NPI

Delaine Cole McCoy, D.D.S.

  • Dentist
  • Mission Viejo, CA
National Provider Identifier
1407190028
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
61969 Issued in CA
Practice address
26137 La Paz Rd Ste 100
Mission Viejo, CA 92691-5325
Phone
(949) 951-1067
Fax
(949) 951-1407
NPI assigned
Nov 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 61969 CA Primary

Addresses

Primary practice location

26137 La Paz Rd Ste 100
Mission Viejo, CA 92691-5325

Mailing address

26137 La Paz Rd Ste 100
Mission Viejo, CA 92691-5325
Phone (949) 951-1067

Other names 1

  • Delaine Cole-Richards Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160314001866 CA Order and Referring Only - DentistPractitioner - Dentist 0547566788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Richard K. Hada, DMD, PC Past Accepting new patients
Roger S. Cullen Dental Corp. Dentist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1353369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1407190028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26137 LA PAZ RD STE 100",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926915325",
            "telephone_number": "949-951-1067",
            "fax_number": "949-951-1407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26137 LA PAZ RD STE 100",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926915325",
            "telephone_number": "949-951-1067",
            "fax_number": "949-951-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "DELAINE",
        "middle_name": "COLE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-20",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "61969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DELAINE",
            "last_name": "COLE-RICHARDS",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.