Healthcare Provider Details

I. General information

NPI: 1770121477
Provider Name (Legal Business Name): TODD AUERBACH, DDS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2019
Last Update Date: 12/13/2019
Certification Date: 12/13/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4972 LAKEVIEW AVE
YORBA LINDA CA
92886-4158
US

IV. Provider business mailing address

4972 LAKEVIEW AVE
YORBA LINDA CA
92886-4158
US

V. Phone/Fax

Practice location:
  • Phone: 714-777-2458
  • Fax: 714-777-2414
Mailing address:
  • Phone: 714-777-2458
  • Fax: 714-777-2414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. TODD AUERBACH
Title or Position: OWNER
Credential: DDS
Phone: 714-777-2458