FOUNTAIN MODERN DENTISTRY AND ORTHODONTICS, LLP (NPI# 1730434622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730434622 |
| Entity Type | Organization |
| Organization Name | FOUNTAIN MODERN DENTISTRY AND ORTHODONTICS, LLP |
| Other Organization Name | FOUNTAIN MODERN DENTISTRY AND ORTHODONTICS |
| Practice Address |
2860 Michelle Drive 2nd Floor Irvine CA 92606 |
| Mailing Address |
6940 Mesa Ridge Parkway Fountain CO 80817 |
| Practice Telephone | 7143682077 |
| Practice Fax Number | 7143682092 |
| Mailing Telephone | 7193824936 |
| Mailing Fax Number | 7193824938 |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2012-07-17 |
| Authorized Official Name | CHARLES RODGERS (DDS/ OWNER) |
| Authorized Official Telephone | 7193824936 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
9356 | CO | Dental Providers |
| Other Name | Type Code |
|---|---|
| Fountain Modern Dentistry and Orthodontics | Doing Business As Name - Organization |
| Street Address |
2860 MICHELLE DRIVE 2ND FLOOR |
| City | IRVINE |
| State | CA |
| Zip Code | 92606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912384967 | Roxanne Betancourt | Behavioral Analyst | 16782 Von Karman Avenue Suite 11, Irvine, CA 92606 | 2015-04-29 |
| 1942552096 | East Haradin | Acupuncturist | 3 Corporate Park, Irvine, CA 92606 | 2012-10-12 |
| 1205100898 | Maria Del Pilar Aguero | Marriage & Family Therapist | 20 Corporate Park #118, Irvine, CA 92606 | 2012-02-29 |
| 1013292077 | Hanah &health, Inc. | Acupuncturist | 2691 Richter Ave Suite 120, Irvine, CA 92606 | 2011-10-20 |
| 1831474345 | Elham Shoja | Psychologist | 8 Corporate Park Suite 300, Irvine, CA 92606 | 2011-10-15 |
| 1154631869 | Frances Lam | Acupuncturist | 2400 Alton Ave., Ste. 208, Irvine, CA 92606 | 2010-10-15 |
| 1174848055 | Oc Physical Therapy Corporation | Clinic/Center | 62 Coporate Park, 145, Irvine, CA 92606 | 2010-04-02 |
| 1770714941 | Yuhong She | Obstetrics & Gynecology | 3500 Barranca Parkway, Ste. 230, Irvine, CA 92606 | 2009-08-05 |
| 1235396136 | Kevin K Lim | Dentist | 16525 Von Karman Ave, #f, Irvine, CA 92606 | 2008-05-19 |
| 1326213075 | Wu Optometric Institute, Inc. | Optometrist | 2710 Alton Pkwy, Ste. 107, Irvine, CA 92606 | 2008-04-24 |
| Find all providers in zip 92606 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992350508 | Masi Hashemian Dds Inc | Dentist | Park Place Dentistry, 2981 Michelson Dr., Suite #b, Irvine, CA 92612 | 2019-08-09 |
| 1467917161 | Lina Isabel Galofre II | Dentist | 27 Willow Tree Ln, Irvine, CA 92612-2253 | 2019-02-06 |
| 1790263713 | Jw Professional Dental Corporation | Dentist | 14785 Jeffrey Rd. Ste 200, Irvine, CA 92618 | 2018-08-01 |
| 1508343237 | Arash Vahdati Nia | Dentist | 6203 Archway, Irvine, CA 92618-8835 | 2018-07-25 |
| 1689192072 | Charlene Tong | Dentist | 9070 Irvine Center Dr Ste 130, Irvine, CA 92618-4690 | 2017-09-06 |
| 1225574353 | Roxanna Baghai Dds. Inc | Dentist | 2500 Alton Pkwy Ste 110, Irvine, CA 92606-5032 | 2017-01-12 |
| 1346798311 | Suryah Habibi | Dentist | 208 Knollglen, Irvine, CA 92614-7490 | 2016-09-19 |
| 1760857536 | Dean Tan D.d.s., Inc | Dentist | 14785 Jeffrey Rd Ste 103, Irvine, CA 92618-0409 | 2015-12-04 |
| 1760854087 | Siavash Golaby Sanajany | Dentist | 17294 Citron, Irvine, CA 92612-2322 | 2015-10-26 |
| 1164806071 | Nuvo Dental of Irvine | Dentist | 22 Odyssey Ste 265, Irvine, CA 92618-7701 | 2015-07-10 |
| Find all providers in IRVINE | ||||
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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.