Active NPI
Evlyne Hersel
- Dentist
- Los Angeles, CA
National Provider Identifier
1013212919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 59814
- Practice address
- 1627 Camden Ave
Apt #305
Los Angeles, CA 90025-3547 - Phone
- (310) 429-8043
- Fax
- (310) 444-7119
- NPI assigned
- Jan 24, 2011
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 59814 | CA | Primary |
Addresses
Primary practice location
1627 Camden Ave
Apt #305
Los Angeles, CA 90025-3547
Mailing address
1627 Camden Ave
Apt #305
Los Angeles, CA 90025-3547
Phone (310) 429-8043
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150904001407 | CA | Order and Referring Only - Dentist | 9931415965 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295827200000",
"number": "1013212919",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1627 CAMDEN AVE",
"address_2": "APT #305",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900253547",
"telephone_number": "310-429-8043",
"fax_number": "310-444-7119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1627 CAMDEN AVE",
"address_2": "APT #305",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900253547",
"telephone_number": "310-429-8043",
"fax_number": "310-444-7119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERSEL",
"first_name": "EVLYNE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-24",
"last_updated": "2011-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "59814",
"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 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.