Active NPI
Evie Vivaldo-Hernandez, RDA
- Dental Assistant
- Los Angeles, CA
National Provider Identifier
1013154103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- 63818
- Practice address
- 5807 N Figueroa St
Los Angeles, CA 90042-4227 - Phone
- (323) 982-0999
- Fax
- (323) 982-0333
- NPI assigned
- Jan 12, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dental Assistant | 126800000X | 63818 | CA | Primary |
Addresses
Primary practice location
5807 N Figueroa St
Los Angeles, CA 90042-4227
Mailing address
5807 N Figueroa St
Los Angeles, CA 90042-4227
Phone (323) 982-0999
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 |
|---|---|---|---|
| 63818 | CA | MD | Dental Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Farid Pakravan, D.D.S., II, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Los Angeles, CA
- NPI 1902020456
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231718400000",
"number": "1013154103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5807 N FIGUEROA ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900424227",
"telephone_number": "323-982-0999",
"fax_number": "323-982-0333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5807 N FIGUEROA ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900424227",
"telephone_number": "323-982-0999",
"fax_number": "323-982-0333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIVALDO-HERNANDEZ",
"first_name": "EVIE",
"credential": "RDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-12",
"last_updated": "2009-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "CA",
"license": "63818",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.