NPIMap

Organization Active NPI

Rudell Gary S. Jacinto, DMD, Inc.

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1033667282
Registry record updated Sep 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
36383 Issued in CA
Legal business name
RUDELL GARY S. JACINTO, DMD, INC.
Practice address
5001 Wilshire Blvd
Suite 212
Los Angeles, CA 90036-6104
Phone
(323) 931-1385
NPI assigned
Sep 16, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2016

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

Authorized official

Name
Rudell Gary Santos Jacinto, DMDNPI 1073660403
Title
Dentist/Owner
Phone
(323) 931-1385

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 36383 CA Primary

Addresses

Primary practice location

5001 Wilshire Blvd
Suite 212
Los Angeles, CA 90036-6104

Mailing address

5001 Wilshire Blvd
Suite 212
Los Angeles, CA 90036-6104
Phone (323) 931-1385

National Provider Directory

National Provider Directory

Locations

5001 Wilshire Blvd
Ste 212
Los Angeles, CA 90036
Phone (323) 931-1385

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1473984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473984000000",
    "number": "1033667282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 WILSHIRE BLVD",
            "address_2": "SUITE 212",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900366104",
            "telephone_number": "323-931-1385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 WILSHIRE BLVD",
            "address_2": "SUITE 212",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900366104",
            "telephone_number": "323-931-1385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUDELL GARY S. JACINTO, DMD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-16",
        "last_updated": "2016-09-16",
        "status": "A",
        "authorized_official_last_name": "JACINTO",
        "authorized_official_first_name": "RUDELL GARY",
        "authorized_official_middle_name": "SANTOS",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "323-931-1385",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "36383",
            "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 Sep 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.