Individual provider Active NPI

Monica Andrea Aquino, DDS

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1043047483
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
110803 Issued in CA
Practice address
5205 Melrose Ave
Los Angeles, CA 90038-3144
Phone
(323) 653-1990
NPI assigned
Sep 18, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 110803 CA Primary

Addresses

Primary practice location

5205 Melrose Ave
Los Angeles, CA 90038-3144

Mailing address

1255 S Goldstone Cir
Anaheim, CA 92804-4669
Phone (714) 496-5022

Other practice location 1

137 N Virgil Ave
Los Angeles, CA 90004-4811
Phone (323) 653-1990

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
I20250917003721 CA Practitioner - Dentist 3173027620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Univ of Calif, Los Angeles School of Dentistry, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6043 Hollywood Blvd
Los Angeles, CA 90028-5411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Los Angeles Free Clinic CurrentSince Jul 6, 2025 Accepting new patients
The Los Angeles Free Clinic Current Accepting new patients
The Los Angeles Free Clinic CurrentSince Jul 6, 2025 Accepting new patients

Locations

137 N Virgil Ave
Los Angeles, CA 90004
Phone (323) 336-8420

5205 Melrose Ave
Los Angeles, CA 90038
Phone (323) 337-1878

6043 Hollywood Blvd
Los Angeles, CA 90028
Phone (323) 653-1990

8405 Beverly Blvd
West Hollywood, CA 90048
Phone (323) 653-1990

Organizations & group practices 3

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": "1726617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1043047483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 S GOLDSTONE CIR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928044669",
            "telephone_number": "714-496-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5205 MELROSE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900383144",
            "telephone_number": "323-653-1990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "137 N Virgil Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900044811",
            "country_code": "US",
            "telephone_number": "323-653-1990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AQUINO",
        "first_name": "MONICA",
        "middle_name": "ANDREA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "110803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.