NPIMap

Organization Active NPI

Derek B. Hauser, DDS, Inc.

Doing business as Lakefront Family Dentistry

  • Dental Clinic/Center
  • Lake Elsinore, CA
National Provider Identifier
1619469194
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
41083 Issued in CA
Legal business name
DEREK B. HAUSER, DDS, INC.
Doing business as
Lakefront Family Dentistry
Practice address
31571 Canyon Estates Dr Ste 117
Lake Elsinore, CA 92532-0471
Phone
(951) 244-9495
NPI assigned
May 31, 2018
Last updated
Dec 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Authorized official

Name
Mrs. Lisa Harrison
Title
Office Admin
Phone
(951) 244-9495

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 41083 CA Primary

Addresses

Primary practice location

31571 Canyon Estates Dr Ste 117
Lake Elsinore, CA 92532-0471

Mailing address

31571 Canyon Estates Dr Ste 117
Lake Elsinore, CA 92532-0471
Phone (951) 244-9495

Other names 1

  • Lakefront Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

31571 Canyon Estates Dr
Ste 117
Lake Elsinore, CA 92532
Phone (951) 244-9495

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607040000000",
    "number": "1619469194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31571 CANYON ESTATES DR STE 117",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925320471",
            "telephone_number": "951-244-9495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31571 CANYON ESTATES DR STE 117",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925320471",
            "telephone_number": "951-244-9495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEREK B. HAUSER, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-31",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OFFICE ADMIN",
        "authorized_official_telephone_number": "951-244-9495",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "41083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakefront Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Elsinore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; 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.