MEDICAL CENTER DENTAL GROUP (NPI# 1952543472) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952543472 |
| Entity Type | Organization |
| Organization Name | MEDICAL CENTER DENTAL GROUP |
| Other Organization Name | MEDICAL CENTER DENTAL GROUP |
| Practice Address |
11160 Warner Ave Suite 303 Fountain Valley CA 92708 |
| Practice Telephone | 7145578492 |
| Practice Fax Number | 7145575392 |
| Mailing Telephone | 7145578492 |
| Mailing Fax Number | 7145575392 |
| Enumeration Date | 2009-03-30 |
| Last Update Date | 2015-05-01 |
| Authorized Official Name | DR. WADID ANTOINE FATTOUCH (DENTIST CEO) |
| Authorized Official Telephone | 7145578492 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
30544 | CA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Medical Center Dental Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023405008 | Medical Center Dental Group | Dentist | 11160 Warner Ave, Suite 303, Fountain Valley, CA 92708-4008 | 2015-04-17 |
| Street Address |
11160 WARNER AVE SUITE 303 |
| City | FOUNTAIN VALLEY |
| State | CA |
| Zip Code | 92708 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396748240 | Steven Craig Chan | Dentist | 11160 Warner Ave, Ste 205, Fountain Valley, CA 92708-4048 | 2005-05-24 |
| 1275091183 | Elizabeth Nguyen | Physician Assistant | 11160 Warner Ave, Fountain Valley, CA 92708-4008 | 2019-03-10 |
| 1205295813 | Keith R Aceron, Dpm | Podiatrist | 11160 Warner Ave, Ste 109, Fountain Valley, CA 92708-4008 | 2016-02-11 |
| 1023405008 | Medical Center Dental Group | Dentist | 11160 Warner Ave, Suite 303, Fountain Valley, CA 92708-4008 | 2015-04-17 |
| 1740524958 | Alan T. Tran M.d., Inc | Specialist | 11160 Warner Ave, Suite 223, Fountain Valley, CA 92708-4008 | 2012-11-15 |
| 1104188176 | Payam Farjoodi Md Inc | Orthopaedic Surgery | 11160 Warner Ave, Fountain Valley, CA 92708-4008 | 2012-06-14 |
| 1255607982 | United Medical Radiology Network | Clinic/Center | 11160 Warner Ave, Suite 105, Fountain Valley, CA 92708-4008 | 2012-03-27 |
| 1750663126 | Brian R Riding | Physician Assistant | 11160 Warner Ave, Suite 311, Fountain Valley, CA 92708-4008 | 2011-09-12 |
| 1194003509 | Ju Gao | Anesthesiology | 11160 Warner Ave, Suite 417, Fountain Valley, CA 92708-4008 | 2011-08-02 |
| 1750670428 | United Medical Imaging Healthcare Inc. | Clinic/Center | 11160 Warner Ave, Suite 105, Fountain Valley, CA 92708-4008 | 2011-04-04 |
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|---|---|---|---|---|
| 1932716222 | Changing Directions Psychological Corporation | Psychologist | 17280 Newhope Street, Suite 4, Fountain Valley, CA 92708 | 2020-09-30 |
| 1124632757 | Neck & Back Pain Specialists, A Balta Chiropractic Corporation | Chiropractor | 10231 Slater Ave. #113, Fountain Valley, CA 92708 | 2020-09-01 |
| 1295205425 | Alexander Nee Dds Inc | Dentist | 337 S Rancho Santa Fe Rd, San Marcos, CA 92708 | 2018-11-30 |
| 1093293052 | Claudia Raquel Santos | Physical Therapist | 18384 Brookhurst Street, Fountain Valley, CA 92708 | 2018-08-01 |
| 1659864338 | Orange County Respiratory Physicians Corp | Internal Medicine | 18111 Brookhurst St Ste 4600, Fountain Valley, CA 92708 | 2018-06-07 |
| 1992297881 | Ereny Abdelmalak Metry | Pharmacist | 9064 Daffodil Ave, Fountain Valley, CA 92708 | 2018-06-06 |
| 1144746348 | Goose Pharma, LLC | Pharmacy | 18049 Magnolia Street, Fountain Valley, CA 92708 | 2017-08-18 |
| 1932622347 | Mayra Alejandra Guerra | Social Worker | 18350 Mt Langley St, Suite 200, Fountain Valley, CA 92708 | 2017-07-18 |
| 1942722129 | Graph Surgery Inc | Plastic Surgery | 10760 Warner Ave, Ste 201, Fountain Valley, CA 92708 | 2017-07-10 |
| 1871022277 | Cathy A Castagna-petersen | Counselor | 10529 Slater Avenue, Fountain Valley, CA 92708 | 2017-06-08 |
| Find all providers in zip 92708 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720692890 | K Itoh Dds Inc | Clinic/Center | 11100 Warner Ave Ste 160, Fountain Valley, CA 92708-7510 | 2020-09-04 |
| 1407074131 | Michael H. Yee D.m.d. Inc | Clinic/Center | 9119 Garfield Ave, Fountain Valley, CA 92708-6560 | 2007-04-20 |
| 1356834188 | Jbs Pacific, Inc | Clinic/Center | 18444 Brookhurst St, Fountain Valley, CA 92708-6706 | 2018-06-06 |
| 1578060612 | James C Chiu Dds Inc | Clinic/Center | 17130 Magnolia St, Fountain Valley, CA 92708-3348 | 2018-04-06 |
| 1487167771 | Andreea Moisiuc Dds Inc. | Clinic/Center | 17037 Brookhurst St Ste 4, Fountain Valley, CA 92708-3623 | 2017-11-09 |
| 1972835148 | Pema Professional Dental Corp | Clinic/Center | 17900 Brookhurst St, Suite A, Fountain Valley, CA 92708-5141 | 2010-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861093551 | Arshdeep Kaur Dental Corporation | Clinic/Center | 345 F St Ste 180, Chula Vista, CA 91910-2648 | 2020-11-08 |
| 1699376350 | Funto Ayanleke Dds | Clinic/Center | 1116 W Tokay St Ste A, Lodi, CA 95240-3852 | 2020-11-07 |
| 1427658541 | Anthony Ngo, Dmd Professional Corporation | Clinic/Center | 18361 Beach Blvd, Huntington Beach, CA 92648-1310 | 2020-10-28 |
| 1912507948 | Alexander Phillips Dds Inc | Clinic/Center | 120 C Ave Ste 100, Coronado, CA 92118-1992 | 2020-10-28 |
| 1912507203 | George K Nguyen Dds, PC | Clinic/Center | 2097 Compton Ave Ste 104, Corona, CA 92881-7289 | 2020-10-27 |
| 1316547524 | Ingersoll Park Marina Gp Dental Corporation | Clinic/Center | 2301 Park Marina Dr Ste 27, Redding, CA 96001-2158 | 2020-10-27 |
| 1396344073 | Charles Kim Dental Corporation | Clinic/Center | 15651 Imperial Hwy Ste 204, La Mirada, CA 90638-1653 | 2020-10-22 |
| 1104425131 | Hossein Malakooti A Dental Corporation | Clinic/Center | 16540 Merrill Ave, Fontana, CA 92335 | 2020-10-21 |
| 1760081129 | Anthony Pham Dental Corp | Clinic/Center | 2658 E Garvey Ave S, West Covina, CA 91791-2113 | 2020-10-17 |
| 1215535182 | Park and Park Dental Group Partnership | Clinic/Center | 473 E Alessandro Blvd Ste A, Riverside, CA 92508-6021 | 2020-10-13 |
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| City | FOUNTAIN VALLEY |
| Zip Code | 92708 |
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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.