Provider Demographics
NPI:1033291133
Name:RICHARD FOUSHEE DDS INC
Entity Type:Organization
Organization Name:RICHARD FOUSHEE DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE PRESIDENT DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:FREDRICK
Authorized Official - Last Name:FOUSHEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-448-0400
Mailing Address - Street 1:6B LIBERTY
Mailing Address - Street 2:SUITE 235
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-5832
Mailing Address - Country:US
Mailing Address - Phone:949-448-0400
Mailing Address - Fax:949-448-0488
Practice Address - Street 1:6B LIBERTY
Practice Address - Street 2:SUITE 235
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-5832
Practice Address - Country:US
Practice Address - Phone:949-448-0400
Practice Address - Fax:949-448-0488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA031610122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherTAX ID#