Active NPI
Lorena Lucero
- Advanced Practice Dental Therapist
- Hermosa Beach, CA
National Provider Identifier
1033689963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Dental Therapist
- License
- HAP829
- Practice address
- 1026 Palm Dr
Hermosa Beach, CA 90254-3729 - Phone
- (360) 688-9908
- NPI assigned
- Dec 4, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Practice Dental Therapist | 125K00000X | HAP829 | CA | Primary |
| Dental Hygienist | 124Q00000X | RDH32422 | CA |
Addresses
Primary practice location
1026 Palm Dr
Hermosa Beach, CA 90254-3729
Mailing address
1026 Palm Dr
Hermosa Beach, CA 90254-3729
Phone (360) 561-7075
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 |
|---|---|---|---|
| RDH32422 | CA | MD | Dental Hygienist |
| HAP829 | CA | MD | Advanced Practice Dental Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619395200000",
"number": "1033689963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1026 PALM DR",
"city": "HERMOSA BEACH",
"state": "CA",
"postal_code": "902543729",
"telephone_number": "360-561-7075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1026 PALM DR",
"city": "HERMOSA BEACH",
"state": "CA",
"postal_code": "902543729",
"telephone_number": "360-688-9908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCERO",
"first_name": "LORENA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-04",
"last_updated": "2021-04-26",
"certification_date": "2021-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "125K00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Dental Therapist",
"state": "CA",
"license": "HAP829",
"primary": true
},
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "RDH32422",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hermosa Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.