Port Dental Care of Long Beach

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PORT DENTAL CARE OF LONG BEACH

Practice address

825 Pacific Ave
Long Beach, CA 90813-4225

Phone

(562) 436-4598

Fax

(562) 437-4598

NPI assigned

Oct 23, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Arceli P Diaz, DDS

Title

President

Phone

(562) 436-4598

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1350950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350950400000",
    "number": "1811240245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 PACIFIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908134225",
            "telephone_number": "562-436-4598",
            "fax_number": "562-437-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 PACIFIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908134225",
            "telephone_number": "562-436-4598",
            "fax_number": "562-437-4598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT DENTAL CARE OF LONG BEACH",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-23",
        "last_updated": "2012-10-23",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "ARCELI",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-436-4598",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kadesha Briana Pope
• Andrea Nicole Popoca
• Chloe Lynn Porcher
• Vinissa Porizek
• Brandon Shapoor Porsandeh
• Port Medical Associate Inc
• Brian Porter
• Jeannine Porter
• Kevin C Porter, DPT
• Kiana Rene Porter

• General Practice Dentistry in Long Beach, CA
• Providers in Long Beach, 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 Oct 23, 2012; 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.