NPIMap

Organization Active NPI

Costa Mesa Corp.

  • Dentist
  • Costa Mesa, CA
National Provider Identifier
1508015603
Registry record updated Sep 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5007 Issued in CA
Legal business name
COSTA MESA CORP.
Practice address
230 E 17TH St
Suite 208
Costa Mesa, CA 92627-3824
Phone
(949) 645-0045
Fax
(949) 645-0055
NPI assigned
Sep 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2008

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

Authorized official

Name
Dr. Rinesh Ganatra, D.D.S.
Title
Owner
Phone
(949) 766-0006

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 5007 CA Primary

Addresses

Primary practice location

230 E 17TH St
Suite 208
Costa Mesa, CA 92627-3824

Mailing address

230 E 17TH St
Suite 208
Costa Mesa, CA 92627-3824
Phone (949) 645-0045

Other names 1

  • SoCal Smiles Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

230 E 17th St
Ste 208
Costa Mesa, CA 92627
Phone (949) 645-0045

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1221177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221177600000",
    "number": "1508015603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 E 17TH ST",
            "address_2": "SUITE 208",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273824",
            "telephone_number": "949-645-0045",
            "fax_number": "949-645-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E 17TH ST",
            "address_2": "SUITE 208",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273824",
            "telephone_number": "949-645-0045",
            "fax_number": "949-645-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTA MESA CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-12",
        "last_updated": "2008-09-12",
        "status": "A",
        "authorized_official_last_name": "GANATRA",
        "authorized_official_first_name": "RINESH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-766-0006",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "5007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SoCal Smiles Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2008; 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.