Pema Professional Dental Corp

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

48536 Issued in CA

Legal business name

PEMA PROFESSIONAL DENTAL CORP

Doing business as

fountain valley dental esthetics

Practice address

17900 Brookhurst St
Suite a
Fountain Valley, CA 92708-5141

Phone

(714) 887-4337

Fax

(714) 887-4339

NPI assigned

Feb 12, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Nilesh Pema, D.D.S

Title

Owner

Phone

(714) 887-4337

Specialties & licenses 1

Addresses

Other names 1

• fountain valley dental esthetics Doing business as

Tax ID family

Fountain Valley Dental Esthetics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pema Professional Dental Corp

  • General Practice Dentistry
  • Fountain Valley, CA
  • NPI 1801034723
  NPD tax ID

Locations

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

{
    "created_epoch": "1265932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265932800000",
    "number": "1972835148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17900 BROOKHURST ST",
            "address_2": "SUITE A",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927085141",
            "telephone_number": "714-887-4337",
            "fax_number": "714-887-4339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17900 BROOKHURST ST",
            "address_2": "SUITE A",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927085141",
            "telephone_number": "714-887-4337",
            "fax_number": "714-887-4339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEMA PROFESSIONAL DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-12",
        "last_updated": "2010-02-12",
        "status": "A",
        "authorized_official_last_name": "PEMA",
        "authorized_official_first_name": "NILESH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-887-4337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "48536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "fountain valley dental esthetics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jillian Pedraza
• Sommer Pedroza, FNP-C
• Giselle Angelica Pelayo
• Harry Pellman, MD
• Pema Professional Dental Corp
• Danielle Pembroke, PHARM D
• Jancy Pen
• Yesenia Betsabe Pena Moran
• Laura Frances Perez-Aoki, NURSE PRACTITIONER
• Rosalia Perez-Flores

• Dental Clinic/Center in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2010; 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.