NPIMap

Organization Active NPI

Grace Dental Image Center

  • Dentist
  • La Habra, CA
National Provider Identifier
1902158397
Registry record updated Oct 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
37587 Issued in CA
Legal business name
GRACE DENTAL IMAGE CENTER
Practice address
1210 S Euclid St
La Habra, CA 90631-7306
Phone
(714) 871-4962
NPI assigned
Oct 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2012

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

Authorized official

Name
Helena Lee
Title
Office Manager
Phone
(714) 871-4962

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 37587 CA Primary

Addresses

Primary practice location

1210 S Euclid St
La Habra, CA 90631-7306

Mailing address

1210 S Euclid St
La Habra, CA 90631-7306
Phone (714) 871-4962

National Provider Directory

National Provider Directory

Locations

1210 S Euclid St
La Habra, CA 90631
Phone (714) 871-4962

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349740800000",
    "number": "1902158397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 S EUCLID ST",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906317306",
            "telephone_number": "714-871-4962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 S EUCLID ST",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906317306",
            "telephone_number": "714-871-4962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE DENTAL IMAGE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-09",
        "last_updated": "2012-10-09",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "HELENA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "714-871-4962"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "37587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Habra, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; 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.