DR. JAIME MATA (NPI# 1780885616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780885616 |
| Entity Type | Individual |
| Full Name | DR. JAIME MATA |
| Credential | DDS |
| Practice Address |
3620 S Bristol St Ste.306 Santa Ana CA 92704-7300 |
| Mailing Address |
3620 S Bristol St Ste. 306 Santa Ana CA 92704-7300 |
| Practice Telephone | 7145565156 |
| Practice Fax Number | 7145565151 |
| Mailing Telephone | 7145565156 |
| Mailing Fax Number | 7145565151 |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
30612 | CA | Dental Providers |
| Street Address |
3620 S BRISTOL ST STE.306 |
| City | SANTA ANA |
| State | CA |
| Zip Code | 92704-7300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144210105 | Mahallati Dental Corporation | Dentist | 3620 S Bristol St, Suite #307, Santa Ana, CA 92704-7300 | 2005-10-21 |
| 1649648825 | Fereshteh Kheyrdan | Dentist | 3620 S Bristol St, Suit # 104, Santa Ana, CA 92704-7300 | 2015-09-04 |
| 1609283126 | Fereshteh Kheyrdan, D.d.s., Inc. | Dentist | 3620 S Bristol St, Suit # 104, Santa Ana, CA 92704-7300 | 2014-07-16 |
| 1962834879 | Navid Mansour Ghods | Dentist | 3620 S Bristol St, Suite #104, Santa Ana, CA 92704-7300 | 2013-08-01 |
| 1487931598 | Shahin Mahallati | Dentist | 3620 S Bristol St, Ste. #307, Santa Ana, CA 92704-7300 | 2011-11-03 |
| 1942444518 | Hiroshi Murotani | Dentist | 3620 S Bristol St, Suite 209, Santa Ana, CA 92704-7300 | 2009-04-28 |
| 1871760827 | Roney Chiropractic Corp | Chiropractor | 3620 S Bristol St, 106, Santa Ana, CA 92704-7300 | 2008-05-09 |
| 1437324555 | Jerome N. Peterson D.d.s. Inc. | Point of Service | 3620 S Bristol St, #302, Santa Ana, CA 92704-7300 | 2008-04-29 |
| 1942415831 | James K. Chen, D.d.s., Inc | Dentist | 3620 S Bristol St, Suite 301, Santa Ana, CA 92704-7300 | 2007-05-13 |
| 1932322260 | Paul Paek Chon | Dentist | 3620 S Bristol St, Suite 206, Santa Ana, CA 92704-7300 | 2007-04-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437771805 | Mohammad Abul-fielat Dds Inc | Dentist | 2341 S Bristol Street, Santa Ana, CA 92704 | 2020-05-08 |
| 1639728538 | Dorothy A Powell | Technician | 722 S. Arapaho Dr, Santa Ana, CA 92704 | 2019-09-04 |
| 1851945646 | Skinzone Medical Inc | Plastic Surgery | 3374 S. Bristol St, Santa Ana, CA 92704 | 2019-07-30 |
| 1215414024 | Sonia Molina | Dietitian, Registered | 2100 W Alton Ave Ste 2, Santa Ana, CA 92704 | 2018-07-24 |
| 1558854612 | Laura Fessler | Nurse Practitioner | 3501 S. Harbor Blvd, Santa Ana, CA 92704 | 2018-06-12 |
| 1104317940 | The Mend of California, LLC | Substance Abuse Rehabilitation Facility | 1909 W. Carlton Place, Santa Ana, CA 92704 | 2018-05-29 |
| 1154811784 | Phleetbo LLC | In Home Supportive Care | 3760 W Mcfadden Ave # B164, Santa Ana, CA 92704 | 2018-05-18 |
| 1588151393 | United Medical Imaging Healthcare, Inc. | Clinic/Center | 3501 S Harbor Blvd Ste 140-b, Santa Ana, CA 92704 | 2018-04-17 |
| 1952811978 | Rising Roads Recovery Services for Women, LLC | Substance Abuse Rehabilitation Facility | 2750 S Harbor Blvd Ste G, Santa Ana, CA 92704 | 2017-10-04 |
| 1427577907 | Advance Oc Surgical Inc. | Clinic/Center | 3500 S. Bristol St., Suite 200, Santa Ana, CA 92704 | 2017-09-15 |
| Find all providers in zip 92704 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427556885 | Better Choice Dental | Dentist | 3760 W Mcfadden Ave Ste D, Santa Ana, CA 92704-1392 | 2018-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982204780 | Richard Koh Dds Ms Inc. | Dentist | 11 Delano, Irvine, CA 92602-2462 | 2020-10-30 |
| 1225641293 | Richard T. Kao, Dds, Phd - Dental Corp. | Dentist | 1660 Willow St Ste 3, San Jose, CA 95125-5101 | 2020-08-28 |
| 1093325722 | Sergio Florencio Jr, Dds, Dmsc, Inc | Dentist | 1802 San Miguel Dr, Walnut Creek, CA 94596-8606 | 2020-08-06 |
| 1205463445 | Sharona Dayan, Dds, Inc | Dentist | 9735 Wilshire Blvd Ste 211, Beverly Hills, CA 90212-2102 | 2020-03-26 |
| 1215573522 | Vanessa Bikhazi | Dentist | 2372 Se Bristol St Ste A, Newport Beach, CA 92660-0755 | 2019-11-21 |
| 1063057008 | Robert Lacrampe | Dentist | 880 W 1st St Apt 526, Los Angeles, CA 90012-2473 | 2019-11-13 |
| 1376194639 | Snow Nakano & Lopez Professional Dental Corporation | Dentist | 868 Auto Center Dr Ste A, Palmdale, CA 93551-4691 | 2019-09-26 |
| 1659926285 | Suman Ramakumar Dds Inc | Dentist | 1171 Homestead Rd Ste 175, Santa Clara, CA 95050-5484 | 2019-08-09 |
| 1912567058 | Andrew Peterson Dmd Ms PC | Dentist | 9856 Hibiscus Ct, Alta Loma, CA 91737-3637 | 2019-06-20 |
| 1124686233 | Danoukh Dental Corp. | Dentist | 12271 La Mirada Blvd Ste 201, La Mirada, CA 90638-1336 | 2019-06-04 |
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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.