Active NPI
Maria H Lima & Raheleh R Pourtemour DDS, Inc
Doing business as Ideal Dental Care
- General Practice Dentistry
- Anaheim, CA
National Provider Identifier
1841655628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 54422
- Legal business name
- MARIA H LIMA & RAHELEH R POURTEMOUR DDS, INC
- Doing business as
- Ideal Dental Care
- Practice address
- 1098 N State College Blvd Ste a
Anaheim, CA 92806-2701 - Phone
- (714) 778-4605
- Fax
- (714) 778-4608
- NPI assigned
- Dec 22, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Lorie Minor Scott
- Title
- Consultant
- Phone
- (949) 258-9828
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 54422 | CA | Primary |
Addresses
Primary practice location
1098 N State College Blvd Ste a
Anaheim, CA 92806-2701
Mailing address
1098 N State College Blvd Ste a
Anaheim, CA 92806-2701
Phone (714) 778-4605
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D24464 | Medicaid | CA |
Other names 1
- Ideal Dental Care
National Provider Directory
National Provider Directory- Tax ID family
- Ideal Dental Care
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Locations
1098 N State College Blvd
Ste A
Anaheim, CA 92806
Phone (714) 778-4605
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1450742400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1450742400000",
"number": "1841655628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1098 N STATE COLLEGE BLVD STE A",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928062701",
"telephone_number": "714-778-4605",
"fax_number": "714-778-4608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1098 N STATE COLLEGE BLVD STE A",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928062701",
"telephone_number": "714-778-4605",
"fax_number": "714-778-4608"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARIA H LIMA & RAHELEH R POURTEMOUR DDS, INC",
"organizational_subpart": "NO",
"enumeration_date": "2015-12-22",
"last_updated": "2015-12-22",
"status": "A",
"authorized_official_last_name": "SCOTT",
"authorized_official_first_name": "LORIE",
"authorized_official_middle_name": "MINOR",
"authorized_official_title_or_position": "CONSULTANT",
"authorized_official_telephone_number": "949-258-9828",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "54422",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "D24464",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Ideal Dental Care",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.