Provider Demographics
NPI:1154659969
Name:DAMIAN L. NEWHART DDS, INC
Entity Type:Organization
Organization Name:DAMIAN L. NEWHART DDS, INC
Other - Org Name:NEWHART ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:DR
Authorized Official - First Name:DAMIAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:NEWHART
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-215-0112
Mailing Address - Street 1:25500 RANCHO NIGUEL ROAD #210
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677
Mailing Address - Country:US
Mailing Address - Phone:949-215-0112
Mailing Address - Fax:949-215-0113
Practice Address - Street 1:25500 RANCHO NIGUEL RD STE 210
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-7373
Practice Address - Country:US
Practice Address - Phone:949-215-0112
Practice Address - Fax:949-215-0113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-07
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47763122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty