NPIMap

Organization Active NPI

Dimple Manchandia DDS, Inc

Doing business as Dentistry Blossom

  • General Practice Dentistry
  • Tustin, CA
National Provider Identifier
1801196514
Registry record updated Oct 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
46882 Issued in CA
Legal business name
DIMPLE MANCHANDIA DDS, INC
Doing business as
Dentistry Blossom
Practice address
18102 Irvine Blvd
Suite 200
Tustin, CA 92780-3402
Phone
(714) 832-7220
Fax
(714) 832-7233
NPI assigned
Oct 27, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2010

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

Authorized official

Name
Dr. Dimple Manchandia, DDSNPI 1013085208
Title
Owner Dentist
Phone
(714) 832-7220

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
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 46882 CA Primary

Addresses

Primary practice location

18102 Irvine Blvd
Suite 200
Tustin, CA 92780-3402

Mailing address

18102 Irvine Blvd
Suite 200
Tustin, CA 92780-3402
Phone (714) 832-7220

Other identifiers 1

IdentifierTypeStateIssuer
1013085208OtherCANPI #

Other names 1

  • Dentistry Blossom Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1288137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288137600000",
    "number": "1801196514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18102 IRVINE BLVD",
            "address_2": "SUITE 200",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803402",
            "telephone_number": "714-832-7220",
            "fax_number": "714-832-7233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18102 IRVINE BLVD",
            "address_2": "SUITE 200",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803402",
            "telephone_number": "714-832-7220",
            "fax_number": "714-832-7233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIMPLE MANCHANDIA DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-27",
        "last_updated": "2010-10-27",
        "status": "A",
        "authorized_official_last_name": "MANCHANDIA",
        "authorized_official_first_name": "DIMPLE",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "714-832-7220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI #",
            "identifier": "1013085208",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dentistry Blossom",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; 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.