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General NPI Number Information
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NPI Number | 1235010646
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Entity Type | Organization
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Legal Business Name | BIRCH DENTAL
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Dates
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Enumeration Date | 09/11/2025
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 5140 BIRCH ST STE 100
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-2169
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Country | US
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Telephone | 949-942-8855
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Fax |
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Provider Business Mailing Address
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Address Line | 5140 BIRCH ST STE 100
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-2169
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Country | US
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Telephone | 949-942-8855
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | IRIS LEE
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Credential |
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Telephone | 949-942-8855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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