Individual provider Active NPI

Daniel Jeffrey Longacre, DDS

  • General Practice Dentistry
  • Laguna Niguel, CA
National Provider Identifier
1649283466
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
28032 Issued in CA
Practice address
30131 Town Center Dr
Suite 150
Laguna Niguel, CA 92677-2034
Phone
(949) 495-2000
Fax
(949) 495-1464
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 28032 CA Primary

Addresses

Primary practice location

30131 Town Center Dr
Suite 150
Laguna Niguel, CA 92677-2034

Mailing address

30131 Town Center Dr
Suite 150
Laguna Niguel, CA 92677-2034
Phone (949) 495-2000

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
28032CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649283466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30131 TOWN CENTER DR",
            "address_2": "SUITE 150",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926772034",
            "telephone_number": "949-495-2000",
            "fax_number": "949-495-1464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30131 TOWN CENTER DR",
            "address_2": "SUITE 150",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926772034",
            "telephone_number": "949-495-2000",
            "fax_number": "949-495-1464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGACRE",
        "first_name": "DANIEL",
        "middle_name": "JEFFREY",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "28032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Niguel, CA

Sources for this page

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