Healthcare Provider Details

I. General information

NPI: 1467541995
Provider Name (Legal Business Name): HEIDI B. STARNES D.D.S.M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 AVOCADO AVE SUITE 210
NEWPORT BEACH CA
92660-7720
US

IV. Provider business mailing address

1401 AVOCADO AVE SUITE 210
NEWPORT BEACH CA
92660-7720
US

V. Phone/Fax

Practice location:
  • Phone: 949-720-8145
  • Fax: 949-720-9702
Mailing address:
  • Phone: 949-720-8145
  • Fax: 949-720-9702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDDS44779
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: