Individual provider Active NPI

Themosthenes Angelus, D.D.S.

  • Dentist
  • Huntington Beach, CA
National Provider Identifier
1457664187
Registry record updated Jul 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
45813 Issued in CA
Practice address
5942 Edinger Ave
Suite 101
Huntington Beach, CA 92649-1763
Phone
(714) 377-4449
Fax
(714) 377-0125
NPI assigned
Jul 22, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 45813 CA Primary

Addresses

Primary practice location

5942 Edinger Ave
Suite 101
Huntington Beach, CA 92649-1763

Mailing address

5942 Edinger Ave
Suite 101
Huntington Beach, CA 92649-1763
Phone (714) 377-4449

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
I20150915002917 CA Order and Referring Only - DentistPractitioner - Dentist 4082921531

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
45813CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279756800000",
    "number": "1457664187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5942 EDINGER AVE",
            "address_2": "SUITE 101",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926491763",
            "telephone_number": "714-377-4449",
            "fax_number": "714-377-0125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5942 EDINGER AVE",
            "address_2": "SUITE 101",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926491763",
            "telephone_number": "714-377-4449",
            "fax_number": "714-377-0125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELUS",
        "first_name": "THEMOSTHENES",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-22",
        "last_updated": "2010-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "45813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.