Active NPI
Tracy Pene, DDS
- Dentist
- Irvine, CA
National Provider Identifier
1912312596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 43901
- Practice address
- 18124 Culver Dr
Ste H
Irvine, CA 92612-2729 - Phone
- (949) 733-1860
- NPI assigned
- Jun 23, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | 43901 | CA | Primary |
Addresses
Primary practice location
18124 Culver Dr
Ste H
Irvine, CA 92612-2729
Mailing address
18124 Culver Dr
Ste H
Irvine, CA 92612-2729
Phone (949) 733-1860
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 |
|---|---|---|---|
| 43901 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gouvion and Grant Dentistry | Past | Accepting new patients | |
| David E. Grant, D.D.S., Inc. | Past | Accepting new patients |
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.
-
- General Practice Dentistry
- Irvine, CA
- NPI 1164656807
-
- General Practice Dentistry
- Irvine, CA
- NPI 1730484320
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403481600000",
"number": "1912312596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18124 CULVER DR",
"address_2": "STE H",
"city": "IRVINE",
"state": "CA",
"postal_code": "926122729",
"telephone_number": "949-733-1860"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18124 CULVER DR",
"address_2": "STE H",
"city": "IRVINE",
"state": "CA",
"postal_code": "926122729",
"telephone_number": "949-733-1860"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENE",
"first_name": "TRACY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-06-23",
"last_updated": "2014-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "43901",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.