Individual provider Active NPI

Vincent Nagel, D.D.S.

  • Dentist
  • Fountain Valley, CA
National Provider Identifier
1891904694
Registry record updated Sep 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
34529 Issued in CA
Practice address
18035 Bushard St
Fountain Valley, CA 92708-5760
Phone
(714) 962-1306
Fax
(714) 964-2366
NPI assigned
May 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 34529 CA Primary

Addresses

Primary practice location

18035 Bushard St
Fountain Valley, CA 92708-5760

Mailing address

18035 Bushard St
Fountain Valley, CA 92708
Phone (714) 962-1306

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150721000515 CA Order and Referring Only - DentistPractitioner - Dentist 1254644289

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34529CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Chris D Nagel DDS Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443052800000",
    "number": "1891904694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18035 BUSHARD ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "92708",
            "telephone_number": "714-962-1306",
            "fax_number": "714-964-2366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18035 BUSHARD ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927085760",
            "telephone_number": "714-962-1306",
            "fax_number": "714-964-2366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGEL",
        "first_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2015-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "34529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.