Jacqueline Ann Nelson, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

103401 Issued in CA

Practice address

801 E Chapman Ave Ste 226
Fullerton, CA 92831-3847

Phone

(714) 680-9500

NPI assigned

Jul 1, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Shahnaz Bonyanpoor

  • Pediatric Dentistry
  • Irvine, CA
  • NPI 1841483740
  NPD (past)

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

{
    "created_epoch": "1530403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1760978803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4523 E WHITE DOVE AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928691939",
            "telephone_number": "602-451-5537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E CHAPMAN AVE STE 226",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313847",
            "telephone_number": "714-680-9500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1467 N Wanda Rd Ste 195",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928675344",
            "country_code": "US",
            "telephone_number": "714-978-4274",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "62 Corporate Park Ste 135",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926063132",
            "country_code": "US",
            "telephone_number": "949-252-9950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4523 E White Dove Ave",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928691939",
            "country_code": "US",
            "telephone_number": "602-451-5537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JACQUELINE",
        "middle_name": "ANN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-01",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "103401",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "10867262-9922",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nelson T. Yen DDS, Ms Inc.
• Bridget Nelson
• Chase Nelson
• Donald Nelson
• Houston Curt Nelson
• Jane Nelson, OTR
• Lowell Gordon Nelson, M.D., PH.D.
• Paul Ernest Nelson, D.D.S.
• Rebecca Lynn Nelson, B.S
• Robert Drummond Nelson, DDS

• Pediatric Dentistry in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; 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.