DR. BEAU MCKENZIE SOARES (NPI# 1205018629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205018629 |
| Entity Type | Individual |
| Full Name | DR. BEAU MCKENZIE SOARES |
| Credential | D.D.S. |
| Practice Address |
500 S Anaheim Hills Rd Suite #222 Anaheim Hills CA 92807-4780 |
| Practice Telephone | 7149745906 |
| Practice Fax Number | 7149745982 |
| Mailing Telephone | 7149745906 |
| Mailing Fax Number | 7149745982 |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2011-06-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 56076 | CA | Dental Providers |
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
56076 | CA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DEA REGISTRATION NUMBER | FS0481147 | 01 |
| CA | DENTAL LICENSE | 56076 | 01 |
| Street Address |
500 S ANAHEIM HILLS RD SUITE #222 |
| City | ANAHEIM HILLS |
| State | CA |
| Zip Code | 92807-4780 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073662490 | Deborah L. Hill | Pediatrics | 500 S Anaheim Hills Rd, Suite 234, Anaheim Hills, CA 92807-4780 | 2007-01-09 |
| 1588770531 | Ana M Hernandez Schneider | Family Medicine | 500 S Anaheim Hills Rd, #128, Anaheim Hills, CA 92807 | 2006-08-22 |
| 1497861728 | Health Group Psychological Services Inc | Clinic/Center | 500 S Anaheim Hills Rd, Suite 202, Anaheim Hills, CA 92807 | 2006-08-21 |
| 1093728503 | Donna Jo Frisch | Internal Medicine | 500 S Anaheim Hills Rd, #206, Anaheim Hills, CA 92807 | 2006-08-14 |
| 1255344768 | Bernadine M Deramo | Internal Medicine | 500 S Anaheim Hills Rd, Ste #206, Anaheim Hills, CA 92807 | 2006-08-14 |
| 1366455875 | Marathon Medical Group Inc | Internal Medicine | 500 S Anaheim Hills Rd, Ste 206, Anaheim Hills, CA 92807 | 2006-08-14 |
| 1629081138 | Terisa Marie Brown-sienko | Nurse Practitioner | 500 S Anaheim Hills Rd, Ste #206, Anaheim Hills, CA 92807 | 2006-08-14 |
| 1538172044 | Caren Hui-min Chen | Internal Medicine | 500 S Anaheim Hills Rd, #206, Anaheim Hills, CA 92807 | 2006-08-14 |
| 1386670974 | Childrens Medical Group of Orange County | Pediatrics | 500 S Anaheim Hills Rd, Suite 110, Anaheim Hills, CA 92807 | 2006-06-24 |
| 1205898095 | Anaheim Hills Medical Imaging, Inc. | Physiological Laboratory | 500 S Anaheim Hills Rd, #136, Anaheim Hills, CA 92807-4780 | 2006-04-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801400759 | Katie Greasby | Marriage & Family Therapist | 509 S. Villa Real Dr. #117, Anaheim Hills, CA 92807 | 2020-09-08 |
| 1386201481 | Joseph Hasrouni | Counselor | Cvs 9753, 5735 E. La Palma Ave, Anaheim, CA 92807 | 2019-05-23 |
| 1144739277 | Luis Antonio Perez | Social Worker | 2112 E 4th St. #107, Santa Ana, CA 92807 | 2017-09-20 |
| 1548781883 | F.foroutan Dds Inc. | Dentist | 5031 E. Orangethorpe Ave., Suite # B-2, Anaheim Hills, CA 92807 | 2017-06-27 |
| 1487101515 | Eloy Ramirez | Counselor | 233 S. Quintana Drive, Anaheim, CA 92807 | 2016-09-07 |
| 1255786448 | K's Loving Care | Custodial Care Facility | 1211 N Amelia St, Anaheim, CA 92807 | 2016-04-26 |
| 1265806673 | Jessica Vickers | Marriage & Family Therapist | 5500 E Santa Ana Canyon Rd Ste 216, Anaheim, CA 92807 | 2015-11-23 |
| 1033596796 | Donovan Garcia Teves | Specialist | 1261 Lakeview Ave., Suite 'a', Anaheim Hills, CA 92807 | 2015-05-01 |
| 1235544354 | Nicole Reaves | Occupational Therapist | 5630 E Santa Ana Canyon Rd Ste 105, Anaheim, CA 92807 | 2014-06-26 |
| 1093143471 | Behrang E Toubak | Counselor | 6381 E Via Arboles, Anaheim, CA 92807 | 2013-10-23 |
| Find all providers in zip 92807 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104962224 | Kim Jon Dipasquale | Dentist | 500 So Anaheim Hills Road, Suite 222, Anaheim Hills, CA 92807 | 2007-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807979 | Ayed Hawatmeh Dds Inc | Dentist | 322 E Foothill Blvd, Pomona, CA 91767 | 2020-10-02 |
| 1114533064 | Alexander V. Antipov, D.d.s., Inc. | Dentist | 911 Reserve Drive, Suite 150, Roseville, CA 95678 | 2020-09-16 |
| 1609493170 | Amir Haghshenas Dds | Dentist | 3880 S Bascom Ave Ste 213, San Jose, CA 95124-2675 | 2020-07-01 |
| 1316568900 | Beech & Reid Dental Partnership | Dentist | 464 E Calaveras Blvd Ste B3, Milpitas, CA 95035-5412 | 2020-05-05 |
| 1518506773 | Francisco Suarez, Dds Inc. | Dentist | 4606 Hollywood Blvd Ste A, Los Angeles, CA 90027-5462 | 2020-01-04 |
| 1831748839 | Slate Dental Corporation | Dentist | 6512 Lonetree Blvd Ste 100, Rocklin, CA 95765-5883 | 2019-09-11 |
| 1255980140 | Dr Maloux Macasaet Saguin Dental Corporation | Dentist | 9800 Topanga Canyon Blvd Ste J, Chatsworth, CA 91311-4075 | 2019-09-04 |
| 1891342267 | Amrollahie and Riman Dental Partnership | Dentist | 1442 Irvine Blvd Ste 225, Tustin, CA 92780-3846 | 2019-08-21 |
| 1548821572 | Hoang Dental Corporation | Dentist | 1356 W Valley Pkwy Ste J, Escondido, CA 92029-2138 | 2019-06-20 |
| 1073173860 | Omfs Care Center Partners | Dentist | 215 N Fresno St Ste 490, Fresno, CA 93701-0000 | 2019-06-14 |
| Find all providers with the same taxonomy | ||||
| City | ANAHEIM HILLS |
| Zip Code | 92807 |
Please comment or provide details below to improve the information on DR. BEAU MCKENZIE SOARES.
| 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.