Active NPI
Felipe De Jesus Vital, DDS.
- Dentist
- Santa Ana, CA
National Provider Identifier
1881883700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 53428
- Practice address
- 505 N Main St FL 2
Santa Ana, CA 92701-4619 - Phone
- (714) 558-4804
- Fax
- (714) 558-3976
- NPI assigned
- Oct 16, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 53428 | CA | Primary |
Addresses
Primary practice location
505 N Main St FL 2
Santa Ana, CA 92701-4619
Mailing address
915 Promontory Dr W
Newport Beach, CA 92660-7368
Phone (949) 673-5171
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
| License | State | Type | Specialty |
|---|---|---|---|
| 53428 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192492800000",
"number": "1881883700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "915 PROMONTORY DR W",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926607368",
"telephone_number": "949-673-5171",
"fax_number": "714-558-3976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 N MAIN ST FL 2",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927014619",
"telephone_number": "714-558-4804",
"fax_number": "714-558-3976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VITAL",
"first_name": "FELIPE",
"middle_name": "DE JESUS",
"credential": "DDS.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-16",
"last_updated": "2007-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "53428",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.