Orange Park Smiles Studio

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

ORANGE PARK SMILES STUDIO

Practice address

8418 E Chapman Ave
Orange, CA 92869-2459

Phone

(714) 984-2050

Fax

(714) 984-2052

NPI assigned

Oct 23, 2023

Organization subpart

No

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

Authorized official

Name

Cecile N Licauco, DDS

Title

Owner/ Dentist

Phone

(714) 984-2050

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698019200000",
    "number": "1740052802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8418 E CHAPMAN AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928692459",
            "telephone_number": "714-984-2050",
            "fax_number": "714-984-2052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8418 E CHAPMAN AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928692459",
            "telephone_number": "714-984-2050",
            "fax_number": "714-984-2052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORANGE PARK SMILES STUDIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-23",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A",
        "authorized_official_last_name": "LICAUCO",
        "authorized_official_first_name": "CECILE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER/ DENTIST",
        "authorized_official_telephone_number": "714-984-2050",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orange Surgical Associates
• Orange Unified School District

• Dental Clinic/Center in Orange, CA
• Providers in Orange, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.