MEDICARE: DR. SCOTT NIVEN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	54490	CA

General Provider Information

NPI Number	:	1891729711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT NIVEN DDS

Provider Business Mailing Address
First Line	:	20280 SW ACACIA ST
Second Line	:	SUITE 120
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-0786
Country	:	US
Telephone Number	:	949-752-6733
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 WESTCLIFF DR STE 202
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-5552
Country	:	US
Telephone Number	:	949-752-6733
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	07/30/2019

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