Sumeet Kumar Srivastava, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

62444 Issued in CA

Practice address

12791 Newport Ave
Suite #200
Tustin, CA 92780-2751

Phone

(714) 730-7777

Fax

(714) 730-7797

NPI assigned

Jul 4, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1372896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372896000000",
    "number": "1679913636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25771 TERRA BELLA AVE",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926535637",
            "telephone_number": "510-543-4936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12791 NEWPORT AVE",
            "address_2": "SUITE #200",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802751",
            "telephone_number": "714-730-7777",
            "fax_number": "714-730-7797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRIVASTAVA",
        "first_name": "SUMEET",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-04",
        "last_updated": "2013-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "62444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Tustin, CA
• Providers in Tustin, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2013; 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.