NPIMap

Organization Active NPI

Jeffrey J. McCullough DMD, Ms, Inc.

Doing business as Los Alamitos Periodontics & Dental Implants

  • Periodontics
  • Los Alamitos, CA
National Provider Identifier
1730672296
Registry record updated Jun 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
62289 Issued in CA
Legal business name
JEFFREY J. MCCULLOUGH DMD, MS, INC.
Doing business as
Los Alamitos Periodontics & Dental Implants
Practice address
4281 Katella Ave Ste 112
Los Alamitos, CA 90720-3502
Phone
(714) 484-8700
NPI assigned
Jun 10, 2018
Last updated
Jun 10, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2018

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

Authorized official

Name
Dr. Jeffrey J McCullough, DMD, MSNPI 1497179253
Title
Owner
Phone
(717) 877-8268

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
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 62289 CA Primary

Addresses

Primary practice location

4281 Katella Ave Ste 112
Los Alamitos, CA 90720-3502

Mailing address

4281 Katella Ave Ste 112
Los Alamitos, CA 90720-3502
Phone (714) 484-8700

Other names 1

  • Los Alamitos Periodontics & Dental Implants Doing business as

National Provider Directory

National Provider Directory

Locations

4281 Katella Ave
Ste 112
Los Alamitos, CA 90720
Phone (562) 860-1611

Practitioners & affiliated clinicians

Practitioners 3

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": "1528588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528588800000",
    "number": "1730672296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4281 KATELLA AVE STE 112",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203502",
            "telephone_number": "714-484-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4281 KATELLA AVE STE 112",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203502",
            "telephone_number": "714-484-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY J. MCCULLOUGH DMD, MS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-10",
        "last_updated": "2018-06-10",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "717-877-8268",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "62289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Los Alamitos Periodontics & Dental Implants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Alamitos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2018; 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.