NPIMap

Organization Active NPI

Theresa M. Nguyenduc DMD, Inc.

Doing business as Capitol Dental Care

  • General Practice Dentistry
  • Costa Mesa, CA
National Provider Identifier
1710174586
Registry record updated Sep 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
39853 Issued in CA
Legal business name
THERESA M. NGUYENDUC DMD, INC.
Doing business as
Capitol Dental Care
Practice address
1202 Bristol St.
Ste. #110
Costa Mesa, CA 92626
Phone
(714) 979-8008
NPI assigned
Sep 26, 2007
Last updated
Sep 26, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2007

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

Authorized official

Name
Dr. Theresa M Nguyenduc, DMDNPI 1982746921
Title
President
Phone
(714) 979-8008

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 39853 CA Primary

Addresses

Primary practice location

1202 Bristol St.
Ste. #110
Costa Mesa, CA 92626

Mailing address

1202 Bristol St.
Ste. #110
Costa Mesa, CA 92626
Phone (714) 979-8008

Other identifiers 1

IdentifierTypeStateIssuer
B39853-01OtherCADENTI-CAL

Other names 1

  • Capitol Dental Care Doing business as

National Provider Directory

National Provider Directory

Locations

1202 Bristol St
Ste 110
Costa Mesa, CA 92626
Phone (714) 979-8008

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190764800000",
    "number": "1710174586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 BRISTOL ST.",
            "address_2": "STE. #110",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "92626",
            "telephone_number": "714-979-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 BRISTOL ST.",
            "address_2": "STE. #110",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "92626",
            "telephone_number": "714-979-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERESA M. NGUYENDUC DMD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2007-09-26",
        "status": "A",
        "authorized_official_last_name": "NGUYENDUC",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-979-8008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "39853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "B39853-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capitol Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.