| Orange County Dental Care | |
|
665 N Tustin St Ste W Orange CA 92867-7148 | |
| (714) 628-9910 | |
| (714) 628-9930 |
| Full Name | Orange County Dental Care |
|---|---|
| Speciality | Dentist |
| Location | 665 N Tustin St Ste W, Orange, California |
| Authorized Official Name and Position | Ali-reza Etemadieh (PRESIDENT) |
| Authorized Official Contact | 9495549931 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Orange County Dental Care 665 N Tustin St Ste W Orange CA 92867-7148 Ph: (714) 628-9910 | Orange County Dental Care 665 N Tustin St Ste W Orange CA 92867-7148 Ph: (714) 628-9910 |
| NPI Number | 1194161281 |
|---|---|
| Provider Enumeration Date | 05/15/2013 |
| Last Update Date | 05/15/2013 |
| Medicare PECOS PAC ID | 0345645172 |
|---|---|
| Medicare Enrollment ID | O20210817003223 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194161281 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 61311 (California) | Primary |
| Provider Name | Ali-reza Etemadieh |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1598019739 PECOS PAC ID: 3870814981 Enrollment ID: I20210715000947 |
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Jay E. Bauman D.d.s., A Professional Dental Corporation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1110 E Chapman Ave Ste 102, Orange, CA 92866 Phone: 714-532-0888 Fax: 714-532-0066 | |
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