Active NPI
Louis James Amendola, D.D.S.
- General Practice Dentistry
- Orange, CA
National Provider Identifier
1003963406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 29547
- Practice address
- 530 S Main St
Orange, CA 92868-4525 - Phone
- (714) 571-3603
- NPI assigned
- Jan 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 29547 | CA | Primary |
Addresses
Primary practice location
530 S Main St
Orange, CA 92868-4525
Mailing address
121 Park View Dr
Fullerton, CA 92835-3532
Phone (714) 571-3603
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29547 | CA | MD | General Practice Dentistry |
Interoperability endpoints
- lamendola@direct.westerndental.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003963406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 PARK VIEW DR",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928353532",
"telephone_number": "714-571-3603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 S MAIN ST",
"city": "ORANGE",
"state": "CA",
"postal_code": "928684525",
"telephone_number": "714-571-3603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMENDOLA",
"first_name": "LOUIS",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "29547",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
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- American Current Care of California, a Medical Corporation
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- American Ground Transportation, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.