Pediatric Dentistry Of San Clemente

LBN: Pediatric Dentistry Of San Clemente
Pediatric Dentistry Of San Clemente is an health care organization with primary practice located at 903 Calle Amanecer Ste 110 , San Clemente CA 92673-6253. The organization recently has only one registered license in Ambulatory Health Care Facilities / Dental, which is considered as the primary health care specialty. Pediatric Dentistry Of San Clemente can be contacted via phone (949) 361-2838, or through Lee, Jacob K via phone (949) 361-2838.

Contact Information

Primary practice address
903 Calle Amanecer Ste 110 San Clemente CA 92673-6253
Phone: (949) 361-2838
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Lee, Jacob K Doctor of Dental Surgery (DDS)
Phone: (949) 361-2838

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Dental 261QD0000X

Profile Details

NPI number 1902687346
LBN Legal business name Pediatric Dentistry Of San Clemente
DBA Doing business as
Authorized official Lee, Jacob K Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 11th, 2023
Last updated Oct 11th, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902687346 NPPES
California Other 1790281202 NPPES
California Other 1083768725 NPPES
California Other 1437689395 NPPES

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