DR. ERIC A PROUTY (NPI# 1609836469) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609836469 |
| Entity Type | Individual |
| Full Name | DR. ERIC A PROUTY |
| Credential | D.M.D. |
| Practice Address |
3151 Airway Ave Suite M2 Costa Mesa CA 92626-4607 |
| Mailing Address |
2 Cuervo Dr Aliso Viejo CA 92656-1742 |
| Practice Telephone | 7146689811 |
| Practice Fax Number | 7146689811 |
| Mailing Telephone | 9498373593 |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2008-03-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
32651 | CA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770110660 | Eric William Prouty | Student in an Organized Health Care Education/Training Program | 701 W Pratt St Rm 474, Baltimore, MD 21201-1023 | 2020-03-23 |
| Street Address |
3151 AIRWAY AVE SUITE M2 |
| City | COSTA MESA |
| State | CA |
| Zip Code | 92626-4607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609342567 | Chris Maa | Acupuncturist | 3151 Airway Ave, Costa Mesa, CA 92626-4607 | 2018-10-18 |
| 1518319946 | Alisa Gardner | Social Worker | 3151 Airway Ave, T2, Costa Mesa, CA 92626-4607 | 2016-07-09 |
| 1821449141 | Nicole Krakora | Naturopath | 3151 Airway Ave, Suite U-3, Costa Mesa, CA 92626-4607 | 2016-06-28 |
| 1841646809 | Charles Fagenholz | Chiropractor | 3151 Airway Ave, U-3, Costa Mesa, CA 92626-4607 | 2016-05-09 |
| 1275997058 | Scbh Laboratory, LLC | Clinical Medical Laboratory | 3151 Airway Ave, Suite N-1, Costa Mesa, CA 92626-4607 | 2016-04-07 |
| 1215392816 | Hpr Laboratories | Clinical Medical Laboratory | 3151 Airway Ave, Unit G1, Costa Mesa, CA 92626-4607 | 2015-12-23 |
| 1134592249 | Robin Giesen | Marriage & Family Therapist | 3151 Airway Ave, Ste. T-3, Costa Mesa, CA 92626-4607 | 2015-11-11 |
| 1194194860 | Samuel T. Enterprise | Counselor | 3151 Airway Ave, Suite D2, Costa Mesa, CA 92626-4607 | 2015-09-23 |
| 1740664614 | Clint Johnson | Counselor | 3151 Airway Ave, D-1, Costa Mesa, CA 92626-4607 | 2015-07-10 |
| 1699158162 | Richard Plaskett | Counselor | 3151 Airway Ave, D-1, Costa Mesa, CA 92626 | 2015-07-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536982 | Sergio Gutierrez | Behavior Technician | 3303 Harbor Blvd., Suite B8, Costa Mesa, CA 92626 | 2020-10-22 |
| 1780201848 | Kelly Chauvet | Behavior Technician | 1503 Nutmeg Place Suite 110, Costa Mesa, CA 92626 | 2020-07-06 |
| 1316564610 | Timo Rosa | Behavior Technician | 1503 Nutmeg Place, Suite 110, Costa Mesa, CA 92626 | 2020-07-02 |
| 1255966115 | Dalia A Sehweil | Behavior Technician | 1111 Baker, Costa Mesa, CA 92626 | 2020-03-11 |
| 1265071096 | Austin Stotelmyre | Behavior Technician | 1111 Baker St Costa Mesa 92626, Costa Mesa, CA 92626 | 2019-12-26 |
| 1396383022 | The Open Table | Community/Behavioral Health | 151 Kalmus Dr. Bldg C, Suite 100, Costa Mesa, CA 92626 | 2019-12-12 |
| 1851933550 | Jennifer Rivera | Behavior Technician | 1111 Baker St. Unit #a, Costa Mesa, CA 92626 | 2019-10-14 |
| 1962053595 | Peter Na | Behavior Technician | Behavior Functions 3303 Harbor Blvd, Ste B8, Costa Mesa, CA 92626 | 2019-09-25 |
| 1346897147 | Jennifer Lopez | Behavior Technician | 555 Alton Blvd Suite 150, Costa Mesa, CA 92626 | 2019-08-26 |
| 1679134084 | Danny Garcia Chiropractic, PC | Chiropractor | 1503 South Coast Drive, Suite 319, Costa Mesa, CA 92626 | 2019-06-26 |
| Find all providers in zip 92626 | ||||
| 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 |
|---|---|---|---|---|
| 1841705746 | Timothy Joseph Rolfes | Dentist | 1530 Baker St #j, Costa Mesa, CA 92626-3752 | 2017-12-13 |
| 1366962334 | Guadalupe A. Mejia Dental Corp. | Dentist | 700 W 19th St., Suite C, Costa Mesa, CA 92627 | 2017-06-21 |
| 1255880928 | Karen Pingyao Yeh | Dentist | 1545 Baker St, Costa Mesa, CA 92626-3731 | 2016-09-22 |
| 1548642846 | De Leon Dentistry General & Cosmestic | Dentist | 1942 Harbor Blvd., Costa Mesa, CA 92627 | 2015-06-23 |
| 1689068884 | M. Zakhary Dds, Inc. | Dentist | 488 E 17th St, 101a, Costa Mesa, CA 92627-3250 | 2015-03-25 |
| 1467716035 | Julianne Shaw | Dentist | 1831 Orange Ave Ste D, Costa Mesa, CA 92627-2839 | 2012-06-28 |
| 1487913471 | Matt G. Farzin Dds, Inc | Dentist | 2969 Harbor Blvd., Costa Mesa, CA 92626 | 2012-05-10 |
| 1558631234 | Sandra Y Rodriguez | Dentist | 2700 Peterson Pl, Unit 49b, Costa Mesa, CA 92626-5300 | 2012-01-11 |
| 1932485299 | Annie Van Anh Nguyen | Dentist | 3105 Monroe Way, Costa Mesa, CA 92626-2826 | 2011-10-31 |
| 1730463662 | Douglas W Lim | Dentist | 728 West 19th St., Suite B, Costa Mesa, CA 92627-6148 | 2011-10-11 |
| Find all providers in COSTA MESA | ||||
| City | COSTA MESA |
| Zip Code | 92626 |
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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.