| Brighter Smile Dental | |
|
2200 Harbor Blvd Ste B230 Costa Mesa CA 92627 | |
| (949) 646-1650 | |
| (949) 646-1576 |
| Full Name | Brighter Smile Dental |
|---|---|
| Speciality | Clinic/Center |
| Location | 2200 Harbor Blvd, Costa Mesa, California |
| Authorized Official Name and Position | Anthony Hung Cao (PRESIDENT OWNER) |
| Authorized Official Contact | 9496461650 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brighter Smile Dental 2200 Harbor Blvd Ste B230 Costa Mesa CA 92627 Ph: (949) 646-1650 | Brighter Smile Dental 2200 Harbor Blvd Ste B230 Costa Mesa CA 92627 Ph: (949) 646-1650 |
| NPI Number | 1164514220 |
|---|---|
| Provider Enumeration Date | 09/28/2006 |
| Last Update Date | 08/26/2019 |
| Medicare PECOS PAC ID | 7911241765 |
|---|---|
| Medicare Enrollment ID | O20181205000198 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164514220 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 43909 (California) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Anthony Hung Cao |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1699857185 PECOS PAC ID: 8820332679 Enrollment ID: I20190305000017 |
| Provider Name | Won Young Kim |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1740737550 PECOS PAC ID: 9335570977 Enrollment ID: I20200514000638 |
| Provider Name | Justine H Hai |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1710433750 PECOS PAC ID: 6305265976 Enrollment ID: I20200930003404 |
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