NPIMap

Organization Active NPI

Rodney D Ida DDS Apc

  • Endodontics
  • Tustin, CA
National Provider Identifier
1922210665
Registry record updated Nov 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
CA36250 Issued in CA
Legal business name
RODNEY D IDA DDS APC
Practice address
17542 Irvine Blvd Ste a
Tustin, CA 92780-3155
Phone
(714) 547-8494
Fax
(714) 547-3448
NPI assigned
May 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2017

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

Authorized official

Name
Dr. Rodney Dean Ida, DDSNPI 1649695537
Title
President
Phone
(714) 547-8494

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 36250 CA
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X CA36250 CA Primary

Addresses

Primary practice location

17542 Irvine Blvd Ste a
Tustin, CA 92780-3155

Mailing address

17542 Irvine Blvd
Suite a
Tustin, CA 92780-3155
Phone (714) 547-8494

National Provider Directory

National Provider Directory

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": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510099200000",
    "number": "1922210665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17542 IRVINE BLVD",
            "address_2": "SUITE A",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803155",
            "telephone_number": "714-547-8494",
            "fax_number": "714-547-3448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17542 IRVINE BLVD STE A",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803155",
            "telephone_number": "714-547-8494",
            "fax_number": "714-547-3448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RODNEY D IDA DDS APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2017-11-08",
        "status": "A",
        "authorized_official_last_name": "IDA",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-547-8494",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "36250",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "CA36250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2017; 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.