Healthcare Provider Details

I. General information

NPI: 1558218941
Provider Name (Legal Business Name): DV DENTISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2026
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1503 S COAST DR STE 201
COSTA MESA CA
92626-1527
US

IV. Provider business mailing address

1503 S COAST DR STE 201
COSTA MESA CA
92626-1527
US

V. Phone/Fax

Practice location:
  • Phone: 714-545-7157
  • Fax: 714-545-5930
Mailing address:
  • Phone: 714-545-7157
  • Fax: 714-545-5930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: ERIC VANEK
Title or Position: DENTIST
Credential: DDS
Phone: 714-545-7157