Individual provider Active NPI

Peter Dolas, DDS

  • General Practice Dentistry
  • Irvine, CA
National Provider Identifier
1619972726
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D32296 Issued in CA
Practice address
Uci Student Health Center Dental Clinic
500 East Peltason Dr
Irvine, CA 92697
Phone
(949) 824-5307
NPI assigned
Jun 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D32296 CA Primary

Addresses

Primary practice location

Uci Student Health Center Dental Clinic
500 East Peltason Dr
Irvine, CA 92697

Mailing address

25422 Trabuco Rd Ste 105-355
Lake Forest, CA 92630
Phone (949) 295-6587

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

LicenseStateTypeSpecialty
D32296CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Uci Student Health Dental Clinic PastSince Dec 12, 2021 Accepting new patients
Kim & Diep Dental Corporation Past Accepting new patients
Peter Dolas,DDS & Stefanie Dolas,DDS Apc Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1619972726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25422 TRABUCO RD STE 105-355",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "92630",
            "telephone_number": "949-295-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UCI STUDENT HEALTH CENTER DENTAL CLINIC",
            "address_2": "500 EAST PELTASON DR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "92697",
            "telephone_number": "949-824-5307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLAS",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "D32296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.