Active NPI
Robert Alan Pine, DDS
- Dentist
- Newport Beach, CA
National Provider Identifier
1477762565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 24590
- Practice address
- 601 Dover Dr Ste 12
Newport Beach, CA 92663-5721 - Phone
- (949) 646-5611
- Fax
- (949) 646-6627
- NPI assigned
- May 22, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 24590 | CA | Primary |
Addresses
Primary practice location
601 Dover Dr Ste 12
Newport Beach, CA 92663-5721
Mailing address
385 Bay View Ter
Costa Mesa, CA 92627-1482
Phone (949) 548-1214
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24590 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477762565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "385 BAY VIEW TER",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926271482",
"telephone_number": "949-548-1214",
"fax_number": "949-646-6627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 DOVER DR STE 12",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926635721",
"telephone_number": "949-646-5611",
"fax_number": "949-646-6627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PINE",
"first_name": "ROBERT",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "24590",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.