Jac Dentistry PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

JAC DENTISTRY PC

Doing business as

Novadent Dental Office

Practice address

901 W Civic Center Dr Ste 180
Santa Ana, CA 92703-2357

Phone

(714) 650-9381

Fax

(714) 516-2234

NPI assigned

Jun 28, 2025

Last updated

Jun 28, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

JAC DENTISTRY PCAs reported in NPPES

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

Authorized official

Name

Ms. Alejandra Berenice De Anda

Title

Office Administrator

Phone

(714) 650-9381

Specialties & licenses 1

Addresses

Other names 1

• NOVADENT DENTAL OFFICE Doing business as

Part of

Jac Dentistry PC

Locations

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

{
    "created_epoch": "1751068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751068800000",
    "number": "1649169434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W CIVIC CENTER DR STE 180",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927032357",
            "telephone_number": "714-650-9381",
            "fax_number": "714-516-2234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W CIVIC CENTER DR STE 180",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927032357",
            "telephone_number": "714-650-9381",
            "fax_number": "714-516-2234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAC DENTISTRY PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JAC DENTISTRY PC",
        "enumeration_date": "2025-06-28",
        "last_updated": "2025-06-28",
        "certification_date": "2025-06-28",
        "status": "A",
        "authorized_official_last_name": "DE ANDA",
        "authorized_official_first_name": "ALEJANDRA",
        "authorized_official_middle_name": "BERENICE",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "714-650-9381",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NOVADENT DENTAL OFFICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark Nicholas Ivanicki, DDS
• Theresa Eileen Iwasaki, PT
• J M Geiss DO Apc
• J Robert West, M.D., Inc (Southern California Dermatology)
• Kumasi Jabulani
• Janice Perpignani Jackman, O.D.
• Anisha Nicole Jackson, PA
• Chantal Tauben Jackson
• Dejaeyon Jackson
• Jessica Parker Jackson

• General Practice Dentistry in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2025; 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.