Active NPI
Omni on Premises
- General Practice Dentistry
- Long Beach, CA
National Provider Identifier
1740040682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- OMNI ON PREMISES
- Practice address
- 4647 Long Beach Blvd Ste D5
Long Beach, CA 90805-6976 - Phone
- (562) 453-0525
- Fax
- (562) 980-0020
- NPI assigned
- Mar 19, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Christopher Doane, DDS
- Title
- Doctor
- Phone
- (805) 450-7329
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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | Primary | ||
| Prosthodontics | 1223P0700X | |||
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | |||
| Oral and Maxillofacial Radiology Dentistry | 1223X0008X |
Addresses
Primary practice location
4647 Long Beach Blvd Ste D5
Long Beach, CA 90805-6976
Mailing address
4647 Long Beach Blvd Ste D5
Long Beach, CA 90805-6976
Phone (562) 453-0525
National Provider Directory
National Provider DirectoryLocations
4647 Long Beach Blvd
Ste D5
Long Beach, CA 90805
Phone (562) 453-0525
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Dentistry
- Goleta, CA
- NPI 1710255971
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710806400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1710806400000",
"number": "1740040682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4647 LONG BEACH BLVD STE D5",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908056976",
"telephone_number": "562-453-0525",
"fax_number": "562-980-0020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4647 LONG BEACH BLVD STE D5",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908056976",
"telephone_number": "562-453-0525",
"fax_number": "562-980-0020"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OMNI ON PREMISES",
"organizational_subpart": "NO",
"enumeration_date": "2024-03-19",
"last_updated": "2024-03-19",
"certification_date": "2024-03-19",
"status": "A",
"authorized_official_last_name": "DOANE",
"authorized_official_first_name": "CHRISTOPHER",
"authorized_official_title_or_position": "DOCTOR",
"authorized_official_telephone_number": "805-450-7329",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": true
},
{
"code": "1223P0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Prosthodontics",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223S0112X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223X0008X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Oral and Maxillofacial Radiology",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.