DR. JENNIFER BLAKE ELI (NPI# 1205103652) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205103652 |
| Entity Type | Individual |
| Full Name | DR. JENNIFER BLAKE ELI |
| Credential | D.M.D. |
| Practice Address |
23321 El Toro Rd Sutie D Lake Forest CA 92630-4825 |
| Mailing Address |
26676 Carranza Dr Mission Viejo CA 92691-4944 |
| Practice Telephone | 9497353259 |
| Enumeration Date | 2011-11-29 |
| Last Update Date | 2011-11-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
52601 | CA | Dental Providers |
| Street Address |
23321 EL TORO RD SUTIE D |
| City | LAKE FOREST |
| State | CA |
| Zip Code | 92630-4825 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881643021 | Southern Orange County Pediatric Associates, Inc. | Pediatrics | 23321 El Toro Rd, Suites F&g, Lake Forest, CA 92630-4825 | 2006-05-07 |
| 1477009454 | Rex Chuang, Dds, Inc. | Dentist | 23321 El Toro Rd, Suite C, Lake Forest, CA 92630-4825 | 2016-08-30 |
| 1497009831 | Keith H Tam Dds Inc | Dentist | 23321 El Toro Rd, Suite C, Lake Forest, CA 92630 | 2012-11-07 |
| 1982916375 | Katherine Danielle Williamson | Pediatrics | 23321 El Toro Rd, Suite F, Lake Forest, CA 92630-4825 | 2010-07-14 |
| 1215250600 | Michael Bissiri | Dentist | 23321 El Toro Rd, Suite B, Lake Forest, CA 92630-4825 | 2010-03-12 |
| 1164694014 | Cuong Ly Md, Inc | Internal Medicine | 23321 El Toro Rd, Suite H, Lake Forest, CA 92630-4825 | 2008-04-01 |
| 1245416239 | Anneke Sager | Nurse Practitioner | 23321 El Toro Rd, Suites F&g, Lake Forest, CA 92630-4825 | 2008-01-21 |
| 1558547547 | Lisa Walpert | Nurse Practitioner | 23321 El Toro Rd, Suites F&g, Lake Forest, CA 92630-4825 | 2008-01-21 |
| 1568589729 | William Young Gregg | Dentist | 23321 El Toro Rd, Suite D, Lake Forest, CA 92630-4825 | 2007-03-23 |
| 1891892204 | Regina Brown | Pediatrics | 23321 El Toro Rd, Suites F&g, Lake Forest, CA 92630-4825 | 2006-09-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194370338 | Ashlee Nicole-morton Sourapas | Midwife | 22672 Lambert Street, Suite 611, Lake Forest, CA 92630 | 2019-08-05 |
| 1134784879 | Scott Mach Enterprises | Custodial Care Facility | 23235 Cavanaugh Road, Lake Forest, CA 92630 | 2019-05-08 |
| 1992368930 | James Daniel Ticorat | Pharmacist | 25051 Calle Arenal, Lake Forest, CA 92630 | 2019-04-16 |
| 1770058349 | Tara L Anderson | Physician Assistant | 22365 El Toro Rd Unit 310, Lake Forest, CA 92630 | 2018-10-10 |
| 1659846855 | Song W. Jung. Dds. Inc | Dentist | 23361 El Toro Rd, Ste 105, Lake Forest, CA 92630 | 2018-10-04 |
| 1326520867 | Katherine Marie Billings | Speech-Language Pathologist | 25454 Navajo, Lake Forest, CA 92630 | 2018-08-31 |
| 1205339611 | Orange County Physiotherapy Services, P.C. | Physical Therapist | 22821 Aspan St., #100, Lake Forest, CA 92630 | 2018-03-12 |
| 1295245587 | Tara Rasta | Chiropractor | 22672 Lambert St Suite 620, Olsen Chiropractic, Lake Forest, CA 92630 | 2017-10-02 |
| 1750800132 | Jessica Aguilar | Marriage & Family Therapist | 21153 Calle De Paseo, Lake Forest, CA 92630 | 2017-09-16 |
| 1275072589 | Anhtu Wu | Pharmacist | 23182 Vista Way, Lake Forest, CA 92630 | 2017-02-20 |
| Find all providers in zip 92630 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265086888 | Peter Wooyoung Lim | Dentist | 26741 Rancho Pkwy Ste 105a, Lake Forest, CA 92630-8710 | 2019-07-31 |
| 1659846855 | Song W. Jung. Dds. Inc | Dentist | 23361 El Toro Rd, Ste 105, Lake Forest, CA 92630 | 2018-10-04 |
| 1669965604 | Brindha Subramanian, Bds, Inc. | Dentist | 23082 Ridge Route Dr Ste A, Lake Forest, CA 92630-3691 | 2018-06-13 |
| 1255823084 | Adem Senalan | Dentist | 150 Little Melody Ln, Lake Forest, IL 60045-1060 | 2018-06-06 |
| 1285137422 | Sandra Sarmeinto Dental Corporation | Dentist | 24400 Muirlands Blvd Ste E, Lake Forest, CA 92630-3946 | 2018-03-14 |
| 1629408430 | H. Botshekan D.d.s | Dentist | 23823 El Toro Rd. Sute E-122, El Toro Dental Care, Lake Forest, CA 92630 | 2013-11-14 |
| 1992046304 | D. Alvarenga, Dds, Inc. | Dentist | 23772 Mercury Rd., Lake Forest, CA 92630 | 2013-03-11 |
| 1720239197 | Mozhgan Molkara | Dentist | 21991 El Toro Rd Ste 6, Lake Forest, CA 92630-6518 | 2008-10-03 |
| 1326294125 | Mary M Farshidpour | Dentist | 26071 Ramjit Ct, Lake Forest, CA 92630-5536 | 2008-08-12 |
| 1396915641 | David C Haggard | Dentist | 21991 El Toro Rd, Lake Forest, CA 92630-6518 | 2008-03-03 |
| Find all providers in LAKE FOREST | ||||
| City | LAKE FOREST |
| Zip Code | 92630 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.