Individual provider Active NPI

Lareine Mikhael, DDS

  • General Practice Dentistry
  • Orange, CA
National Provider Identifier
1972198737
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
105975 Issued in CA
Practice address
2393 N Tustin St Ste a
Orange, CA 92865-3714
Phone
(714) 453-0215
NPI assigned
Mar 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 105975 CA Primary

Addresses

Primary practice location

2393 N Tustin St Ste a
Orange, CA 92865-3714

Mailing address

2393 N Tustin St Ste a
Orange, CA 92865-3714
Phone (714) 453-0215

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210719003481 CA Order and Referring Only - DentistPractitioner - Dentist 3870996515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105975CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Nguyen Dental Corporation General Practice PastSince Mar 7, 2021 Accepting new patients

Organizations & group practices 1

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": "1614729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1972198737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2393 N TUSTIN ST STE A",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928653714",
            "telephone_number": "714-453-0215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2393 N TUSTIN ST STE A",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928653714",
            "telephone_number": "714-453-0215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKHAEL",
        "first_name": "LAREINE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-03",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "105975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.