Individual provider Active NPI

Rebecca La, DMD

  • Dentist
  • San Diego, CA
National Provider Identifier
1023722089
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS108358 Issued in CA
Practice address
2171 Ulric St Ste 100
San Diego, CA 92111-6691
Phone
(858) 268-8188
NPI assigned
Jan 12, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS108358 CA Primary

Addresses

Primary practice location

2171 Ulric St Ste 100
San Diego, CA 92111-6691

Mailing address

7758 Prairie Shadow Rd
San Diego, CA 92126-8018
Phone (858) 610-2786

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230711001881 CA Order and Referring Only - DentistPractitioner - Dentist 8729447545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS108358CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Catherine Le, DDS, Inc. PastSince Jan 15, 2023 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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1673481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1023722089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7758 PRAIRIE SHADOW RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921268018",
            "telephone_number": "858-610-2786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2171 ULRIC ST STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921116691",
            "telephone_number": "858-268-8188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LA",
        "first_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-12",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS108358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.