Joseph L Packer, DMD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

58887 Issued in CA

Practice address

15825 Laguna Canyon Rd
Irvine, CA 92618-2125

Phone

(949) 789-8989

Fax

(949) 453-0970

NPI assigned

Sep 11, 2007

Last updated

Sep 28, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317168000000",
    "number": "1699960864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28081 EDELWEISS CT",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926777006",
            "telephone_number": "702-292-0759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15825 LAGUNA CANYON RD",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926182125",
            "telephone_number": "949-789-8989",
            "fax_number": "949-453-0970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKER",
        "first_name": "JOSEPH",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-11",
        "last_updated": "2011-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "58887",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NV",
            "license": "5560",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "UT",
            "license": "6657777-9922",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pacific Pain & Vein Apc
• Pacific Shores Medical Group, Inc
• Pacific Spine & Sports, Inc.
• Isabela Pacis
• Aimee Pack, BCBA
• Kanei Padhya
• Padideh Shafiei DMD, Inc. (Spectrum Dentistry)
• Janette Padilla
• Maria Padilla, FNP, PHN, RN
• Michael Andrew Padilla, L.AC.

• Endodontics in Irvine, CA
• Providers in Irvine, CA by specialty
• Endodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.