Acevedo Dental Office, Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

55423 Issued in CA

Legal business name

ACEVEDO DENTAL OFFICE, INC.

Practice address

2800 N Main St Unit 1010
Santa Ana, CA 92705-6608

Phone

(714) 617-7979

Fax

(714) 617-7278

NPI assigned

Aug 21, 2017

Last updated

Aug 21, 2017By the provider in NPPES

Organization subpart

Yes

Parent organization

ACEVEDO DENTAL OFFICE INC.As reported in NPPES

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

Authorized official

Name

Lidya Soraya Acevedo, D.D.S

Title

Owner

Phone

(323) 724-1010

Specialties & licenses 1

Addresses

Part of

Acevedo Dental Office Inc

Locations

Practitioners 2

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.

• Magdalena B Minkowicz

  • General Practice Dentistry
  • Santa Ana, CA
  • NPI 1568014686
  NPD (past)
• Camilo Jose Morales Acevedo, DDS

  • Dentist
  • Montebello, CA
  • NPI 1023804200
  NPD (past)

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

{
    "created_epoch": "1503273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503273600000",
    "number": "1790201762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 N MAIN ST UNIT 1010",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927056608",
            "telephone_number": "714-617-7979",
            "fax_number": "714-617-7278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N MAIN ST UNIT 1010",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927056608",
            "telephone_number": "714-617-7979",
            "fax_number": "714-617-7278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACEVEDO DENTAL OFFICE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ACEVEDO DENTAL OFFICE INC.",
        "enumeration_date": "2017-08-21",
        "last_updated": "2017-08-21",
        "status": "A",
        "authorized_official_last_name": "ACEVEDO",
        "authorized_official_first_name": "LIDYA",
        "authorized_official_middle_name": "SORAYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-724-1010",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2017; 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.