Organization Active NPI

State College Dental Group

  • General Practice Dentistry
  • Anaheim, CA
National Provider Identifier
1871628065
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
STATE COLLEGE DENTAL GROUP
Practice address
330 N State College Blvd Ste 105
Anaheim, CA 92806-2924
Phone
(714) 772-5005
NPI assigned
Feb 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Marius Badea, D.D.S.
Title
Dentist , Officer
Phone
(714) 772-5005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

330 N State College Blvd Ste 105
Anaheim, CA 92806-2924

Mailing address

330 N State College Blvd Ste 105
Anaheim, CA 92806-2924
Phone (714) 772-5005

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871628065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N STATE COLLEGE BLVD STE 105",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928062924",
            "telephone_number": "714-772-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N STATE COLLEGE BLVD STE 105",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928062924",
            "telephone_number": "714-772-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE COLLEGE DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BADEA",
        "authorized_official_first_name": "MARIUS",
        "authorized_official_title_or_position": "DENTIST , OFFICER",
        "authorized_official_telephone_number": "714-772-5005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; 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.