Provider Demographics
NPI:1942608435
Name:ASSISTANCE LEAGUE OF NEWPORT-MESA CALIFORNIA
Entity type:Organization
Organization Name:ASSISTANCE LEAGUE OF NEWPORT-MESA CALIFORNIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTAL ADVISOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ZEE
Authorized Official - Last Name:HAMADA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-645-2882
Mailing Address - Street 1:2220 FAIRVIEW ROAD
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627
Mailing Address - Country:US
Mailing Address - Phone:949-645-6929
Mailing Address - Fax:949-645-3919
Practice Address - Street 1:2220 FAIRVIEW ROAD
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627
Practice Address - Country:US
Practice Address - Phone:949-645-2882
Practice Address - Fax:949-645-2191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-15
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA071231223E0200X, 1223X0400X, 124Q00000X, 126800000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Single Specialty
No126800000XDental ProvidersDental AssistantGroup - Single Specialty