Active NPI
Venkatesh Dwarnal, DDS
- General Practice Dentistry
- Huntington Park, CA
National Provider Identifier
1023162674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 29704
- Practice address
- 2406 E Florence Ave
Huntington Park, CA 90255 - Phone
- (323) 581-0894
- Fax
- (323) 581-1827
- NPI assigned
- Jan 22, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 29704 | CA | Primary |
Addresses
Primary practice location
2406 E Florence Ave
Huntington Park, CA 90255
Mailing address
2406 E Florence Ave
Huntington Park, CA 90255
Phone (323) 581-0894
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 501059 | Other | CA | MEDI-CAL |
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 |
|---|---|---|---|
| 29704 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023162674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2406 E FLORENCE AVE",
"city": "HUNTINGTON PARK",
"state": "CA",
"postal_code": "90255",
"telephone_number": "323-581-0894",
"fax_number": "323-581-1827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2406 E FLORENCE AVE",
"city": "HUNTINGTON PARK",
"state": "CA",
"postal_code": "90255",
"telephone_number": "323-581-0894",
"fax_number": "323-581-1827"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DWARNAL",
"first_name": "VENKATESH",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "29704",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL",
"identifier": "501059",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Huntington Park, CA
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.