Jason Terry Bock, DDS MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

32694 Issued in CA

Practice address

420 W Central Ave
Sutie F
Brea, CA 92821-3001

Phone

(714) 990-4114

Fax

(714) 529-2559

NPI assigned

Sep 25, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190764800000",
    "number": "1609063528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W CENTRAL AVE",
            "address_2": "SUITE F",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928213001",
            "telephone_number": "714-990-4114",
            "fax_number": "714-529-2559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W CENTRAL AVE",
            "address_2": "SUTIE F",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928213001",
            "telephone_number": "714-990-4114",
            "fax_number": "714-529-2559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCK",
        "first_name": "JASON",
        "middle_name": "TERRY",
        "name_prefix": "Dr.",
        "credential": "DDS MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-25",
        "last_updated": "2007-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "32694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Brea, CA
• Providers in Brea, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.

Verify at the official NPI Registry.