Individual provider Active NPI

Timothy C. Randall, DDS

  • General Practice Dentistry
  • Laguna Hills, CA
National Provider Identifier
1821204785
Registry record updated Oct 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DY034891 Issued in CA
Practice address
25251 Paseo de Alicia Ste 200
Laguna Hills, CA 92653
Phone
(949) 348-7660
Fax
(949) 340-8049
NPI assigned
May 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DY034891 CA Primary

Addresses

Primary practice location

25251 Paseo de Alicia Ste 200
Laguna Hills, CA 92653

Mailing address

25251 Paseo de Alicia Ste 200
Laguna Hills, CA 92653-4616
Phone (949) 748-4949

Other practice location 1

26932 Oso Pkwy Ste 280
Mission Viejo, CA 92691-5815
Phone (949) 348-7660

Other practice location 2

24953 Paseo De Valencia Ste 6C
Laguna Hills, CA 92653-4337
Phone (949) 348-7660

Other practice location 3

25251 Paseo De Alicia Ste 200
Laguna Hills, CA 92653
Phone (949) 348-7660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DY034891CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1821204785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25251 PASEO DE ALICIA STE 200",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926534616",
            "telephone_number": "949-748-4949",
            "fax_number": "949-340-8049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25251 PASEO DE ALICIA STE 200",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "92653",
            "telephone_number": "949-348-7660",
            "fax_number": "949-340-8049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26932 Oso Pkwy Ste 280",
            "address_purpose": "LOCATION",
            "city": "Mission Viejo",
            "state": "CA",
            "postal_code": "926915815",
            "country_code": "US",
            "telephone_number": "949-348-7660",
            "fax_number": "949-215-7616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24953 Paseo De Valencia Ste 6C",
            "address_purpose": "LOCATION",
            "city": "Laguna Hills",
            "state": "CA",
            "postal_code": "926534337",
            "country_code": "US",
            "telephone_number": "949-348-7660",
            "fax_number": "949-340-8049",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25251 Paseo De Alicia Ste 200",
            "address_purpose": "LOCATION",
            "city": "Laguna Hills",
            "state": "CA",
            "postal_code": "92653",
            "country_code": "US",
            "telephone_number": "949-348-7660",
            "fax_number": "949-340-8049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "TIMOTHY",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DY034891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2019; 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.