PELICAN POINT DENTAL (NPI# 1033606991) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033606991 |
| Entity Type | Organization |
| Organization Name | PELICAN POINT DENTAL |
| Practice Address |
31103 Rancho Viejo Road Ste D2444 San Juan Capistrano CA 92675 |
| Practice Telephone | 5629640877 |
| Mailing Telephone | 5629640877 |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2018-04-17 |
| Authorized Official Name | DR. NICOLE ELIZABETH KUSKE (DENTIST) |
| Authorized Official Telephone | 5629640877 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 57535 | CA | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
57535 | CA | Dental Providers |
| Y | 1223D0001X |
Dentist Specialization: Dental Public Health |
57535 | CA | Dental Providers |
| Street Address |
31103 RANCHO VIEJO ROAD STE D2444 |
| City | SAN JUAN CAPISTRANO |
| State | CA |
| Zip Code | 92675 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184268088 | Dana Caballero | Social Worker | 30240 Racho Viejo Rd, Suite C-1, San Juan Capistrano, CA 92675 | 2019-11-04 |
| 1801363858 | Hgrt Medical Group Inc | Internal Medicine | 31741 Rancho Hill Viejo Road, San Juan Capistrano, CA 92675 | 2018-10-29 |
| 1487132551 | Alex James Vanderschelden | Chiropractor | 36461 Rancho Viejo Rd. Suiete 103, Suite 103, San Juan Capistrano, CA 92675 | 2018-08-01 |
| 1295224780 | Gateway Healthcare, Inc. | Skilled Nursing Facility | 29222 Rancho Viejo Rd Ste 127, San Juan Capistrano, CA 92675 | 2018-05-09 |
| 1639677511 | Ocean Hills Recovery Inc. | Substance Abuse Rehabilitation Facility | 27126b Paseo Espada, Suite 725, San Juan Capistrano, CA 92675 | 2018-01-25 |
| 1679091441 | D Dawn Maxwell | Counselor | 30950 Rancho Viejo Rd Suite 225, San Juan Capistrano, CA 92675 | 2017-08-31 |
| 1417491523 | Terry D'amico | Physical Therapy Assistant | 32961 Calle Miguel, San Juan Capistrano, CA 92675 | 2016-12-08 |
| 1235580556 | Marriage Made Better Relationship Counseling | Community/Behavioral Health | 30200 Rancho Viejo Road, Suite D, San Juan Capistrano, CA 92675 | 2016-06-28 |
| 1679923288 | Shanti Recovery Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 31211 Casa Grande Drive, San Juan Capistrano, CA 92675 | 2016-06-14 |
| 1093169542 | Carolyn Du | Registered Nurse | 31201 Paseo Miraloma, San Juan Capistrano, CA 92675 | 2016-04-21 |
| Find all providers in zip 92675 | ||||
| Taxonomy Code | 1223D0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Dental Public Health |
| The science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice that serves the community as a patient rather than the individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336740216 | Thomas Robert Matthew Simpson | Dentist | 1387 Kirsten Ct, Red Bluff, CA 96080-4905 | 2020-11-05 |
| 1629683339 | Jisoo Choe | Dentist | 232 E 2nd St Apt 451, Los Angeles, CA 90012-4098 | 2020-09-10 |
| 1831703479 | Seville Dental Group, Inc. | Dentist | 7705 Seville Ave Ste A, Huntington Park, CA 90255-6570 | 2020-09-01 |
| 1114537842 | Sepideh Rahmani | Dentist | 945 Orchard Creek Ln Ste 200, Lincoln, CA 95648-8473 | 2020-08-06 |
| 1861018160 | Dentists On Wheels | Dentist | 2210 Gladstone Dr, Pittsburg, CA 94565-5101 | 2020-06-22 |
| 1558997148 | S. Safarian Dmd Inc | Dentist | 955 Boardwalk Ste 304, San Marcos, CA 92078-2659 | 2020-03-16 |
| 1902455884 | Aileen Arce Dds Incorporated | Dentist | 345 F St Ste 140, Chula Vista, CA 91910-2632 | 2019-09-04 |
| 1972156420 | Jessica R Yang | Dentist | 6950 Santa Teresa Blvd Ste D, San Jose, CA 95119-1300 | 2019-07-23 |
| 1447811070 | Roop Mayall | Dentist | 1215 Plumas St Ste 52, Yuba City, CA 95991-3492 | 2019-06-25 |
| 1699242933 | Albert Young | Dentist | Naval Medical Ctr Bob Wilson Dr, San Diego, CA 92134-0001 | 2018-10-25 |
| Find all providers with the same taxonomy | ||||
| City | SAN JUAN CAPISTRANO |
| Zip Code | 92675 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.