Individual provider Active NPI

Christine Debaz, DMD

  • General Practice Dentistry
  • Brea, CA
National Provider Identifier
1902334238
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
003858 Issued in OH
Practice address
307 N Brea Blvd
Brea, CA 92821-4053
Phone
(714) 594-7009
NPI assigned
May 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 003858 OH Primary
General Practice Dentistry 1223G0001X 104941 CA
General Practice Dentistry 1223G0001X 30.025307 OH

Addresses

Primary practice location

307 N Brea Blvd
Brea, CA 92821-4053

Mailing address

740 S Carriage Cir
Anaheim, CA 92807-4905
Phone (440) 488-5390

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
104941CAMDGeneral Practice Dentistry
30.025307OHMDGeneral Practice Dentistry
003858OHMDHome Health Agency

Practice roles

OrganizationSpecialtyStatusNew patients
John Y Chung DMD Inc General Practice CurrentSince Apr 23, 2023 Accepting new patients
Lena S Debaz DMD Dental Practice CurrentSince Feb 8, 2023 Accepting new patients

Locations

307 N Brea Blvd
Brea, CA 92821
Phone (714) 594-7009

Organizations & group practices 2

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": "1496188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1902334238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 S CARRIAGE CIR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928074905",
            "telephone_number": "440-488-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 N BREA BLVD",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928214053",
            "telephone_number": "714-594-7009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBAZ",
        "first_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-31",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "003858",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "104941",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.025307",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brea, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; 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.