H. de Bourg DMD, Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

48096 Issued in CA

Legal business name

H. DE BOURG DMD, INC.

Practice address

2401 W Chapman Ave Ste 203
Orange, CA 92868-2327

Phone

(714) 935-0020

NPI assigned

Apr 1, 2012

Last updated

Apr 1, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Juanita Contreras

Title

Office Manager

Phone

(714) 935-0029

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1333238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333238400000",
    "number": "1447526611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 W CHAPMAN AVE STE 203",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928682327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W CHAPMAN AVE STE 203",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928682327",
            "telephone_number": "714-935-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H. DE BOURG DMD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-01",
        "last_updated": "2012-04-01",
        "status": "A",
        "authorized_official_last_name": "CONTRERAS",
        "authorized_official_first_name": "JUANITA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "714-935-0029",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Orange, CA
• Providers in Orange, CA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2012; 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.