Coury Staadecker in Newport Beach - Periodontics
Coury Staadecker - NPI 1932258332
Coury Staadecker is a Periodontics in Newport Beach, California. Coury Staadecker practices all healthcare services and medical treatments related to Periodontics. The NPI Number for Coury Staadecker is 1932258332. The last update date is 2012-05-17.
Coury Staadecker's current location address is 1441 Avocado Ave, Newport Beach, California. You can contact this provider via phone number 9496409475 and fax number 9496402621. The mailing address for Coury Staadecker is 1441 Avocado Ave, Newport Beach, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Coury Staadecker |
|---|---|
| Address | 1441 Avocado Ave, Newport Beach, California |
| Phone Number | 9496409475 |
| Fax Number | 9496402621 |
| Sole Proprietor | Y |
| Credentials | D.D.S., M. |
NPI Number Detail
| NPI Number | 1932258332 |
|---|---|
| Provider Enumeration Date | 2007-01-09 |
| Last Updated Date | 2012-05-17 |
Provider Mailing Address Detail
| Address | 1441 Avocado Ave |
|---|---|
| City | Newport Beach |
| State | California (CA) |
| Post Code | 926607721 |
| Phone Number | 9496409475 |
| Fax Number | 9496402621 |
Provider's Primary Taxonomy Detail
| Speciality | Periodontics |
|---|---|
| Taxonomy | 1223P0300X |
| Licence No | 48025 |
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Definition: 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 structure |
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What is the unique 10-digit identifier code issued to Coury Staadecker by the Centers for Medicare & Medicaid Services?
The Coury Staadecker has been assigned the NPI (National Provider Identifier) 1932258332 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Where is the Coury Staadecker located?
The Coury Staadecker is located at 1441 Avocado Ave, Newport Beach, CA 926607721.
What is Coury Staadecker's specialized field of practice, and what is the corresponding taxonomy classification code?
The Coury Staadecker's area of specialization is Periodontics, and the corresponding taxonomy code that categorizes this field of practice is 1223P0300X.
On what date did Coury Staadecker receive its 1932258332 assignment from the Centers for Medicare & Medicaid Services?
The Coury Staadecker was assigned its 1932258332 on 2007-01-09, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information regarding Coury Staadecker, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Coury Staadecker, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2012-05-17.
NPI Number: 1902809924
Address: 2400 W Main St, Rock Hill, SC