NPIMap

Organization Active NPI

Pacifi Dental Clinic

  • General Practice Dentistry
  • Santa Ana, CA
National Provider Identifier
1962791459
Registry record updated Apr 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
47897 Issued in CA
Legal business name
PACIFI DENTAL CLINIC
Practice address
1217 E 17TH St
Santa Ana, CA 92701-2640
Phone
(714) 550-7172
Fax
(714) 550-7173
NPI assigned
Apr 5, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2011

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

Authorized official

Name
Dr. Jorge Luis Geronimo, D.D.S.
Title
Dentist
Phone
(714) 550-7172

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 47897 CA Primary

Addresses

Primary practice location

1217 E 17TH St
Santa Ana, CA 92701-2640

Mailing address

1217 E 17TH St
Santa Ana, CA 92701-2640
Phone (714) 550-7172

National Provider Directory

National Provider Directory
Tax ID family
Jorge L Geronimo Ddsprofdental Cor5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the 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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301961600000",
    "number": "1962791459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 E 17TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927012640",
            "telephone_number": "714-550-7172",
            "fax_number": "714-550-7173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 E 17TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927012640",
            "telephone_number": "714-550-7172",
            "fax_number": "714-550-7173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFI DENTAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-05",
        "last_updated": "2011-04-05",
        "status": "A",
        "authorized_official_last_name": "GERONIMO",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "LUIS",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "714-550-7172",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "47897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; 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.