Brindha Subramanian, BDS, Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

58339 Issued in CA

Legal business name

BRINDHA SUBRAMANIAN, BDS, INC.

Practice address

23082 Ridge Route Dr Ste a
Lake Forest, CA 92630-3691

Phone

(949) 837-2766

NPI assigned

Jun 13, 2018

Organization subpart

No

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

Authorized official

Name

John Fehmer

Title

Officer

Phone

(562) 577-5641

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665532800000",
    "number": "1669965604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23082 RIDGE ROUTE DR STE A",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926303691",
            "telephone_number": "949-837-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23082 RIDGE ROUTE DR STE A",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926303691",
            "telephone_number": "949-837-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRINDHA SUBRAMANIAN, BDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-13",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A",
        "authorized_official_last_name": "FEHMER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "562-577-5641"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "58339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL BOARD OF CALIFORNIA",
            "identifier": "58339",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Lake Forest, CA
• Providers in Lake Forest, 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 Oct 12, 2022; 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.