Paul A Nissen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

55015 Issued in CA

Practice address

72027 Highway 111
Suite C
Rancho Mirage, CA 92270-4961

Phone

(760) 340-5155

Fax

(760) 340-1607

NPI assigned

Nov 5, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cabanas and Lee Dental Corporation

  • General Practice Dentistry
  • Rancho Mirage, CA
  • NPI 1083893580
  NPD (past)

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194220800000",
    "number": "1881874170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 MICHELLE",
            "address_2": "2ND FLOOR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926061009",
            "telephone_number": "714-508-3600",
            "fax_number": "714-368-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72027 HIGHWAY 111",
            "address_2": "SUITE C",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704961",
            "telephone_number": "760-340-5155",
            "fax_number": "760-340-1607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISSEN",
        "first_name": "PAUL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-05",
        "last_updated": "2007-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trang Huyen Nguyen, DDS
• VI Nguyen, PHARMD
• Nhat Canh Nguyen-Minh MD Inc
• Katelyn Linne Nielsen, MD
• Michael Kien Ninh, MD
• Noel Curry MD Facp a Professional Corporation
• Nicole M Noel, MD
• Northland Hearing Center, Inc
• Shlomo Noskow
• NP Gi Consultants a Nursing Corporation

• General Practice Dentistry in Rancho Mirage, CA
• Providers in Rancho Mirage, 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 Nov 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.