Healthcare Provider Details

I. General information

NPI: 1770402786
Provider Name (Legal Business Name): TAYNA SOARES DE OLIVEIRA HURLEY DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3167 BERN DR
LAGUNA BEACH CA
92651-2005
US

IV. Provider business mailing address

3167 BERN DR
LAGUNA BEACH CA
92651-2005
US

V. Phone/Fax

Practice location:
  • Phone: 949-446-2307
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number113503
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: