Latrisha Ilas, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

106463 Issued in CA

Practice address

1206 N Capitol Ave Ste 101
San Jose, CA 95132-2572

Phone

(408) 928-1450

Fax

(408) 928-1454

NPI assigned

Jul 28, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Colin S. Ilas D.D.S.

  • General Practice Dentistry
  • San Jose, CA
  • NPI 1629616479
  NPD
• Colin S. Ilas D.D.S.

  • General Practice Dentistry
  • Concord, CA
  • NPI 1427698877
  NPD (past)

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1053084764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 N CAPITOL AVE STE 101",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951322572",
            "telephone_number": "408-928-1450",
            "fax_number": "408-928-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 N CAPITOL AVE STE 101",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951322572",
            "telephone_number": "408-928-1450",
            "fax_number": "408-928-1454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2030 Diamond Blvd Ste 25",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "CA",
            "postal_code": "945205753",
            "country_code": "US",
            "telephone_number": "925-687-8000",
            "fax_number": "925-687-8223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ILAS",
        "first_name": "LATRISHA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "106463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Il Hwan Park Chiropractic Clinic
• Il Hwan Park Chiropractic Professional Corporation
• Nili Ilani
• Dominique Ilaoa
• Colin S. Ilas, D.D.S.
• Patricia Ilas, DDS
• Iva Sikirica Ilic, M.D.
• Amylin Illorde
• Ilya Sabsovich MD Inc a Medical Corporation
• Brittney Sau Lin Imada

• General Practice Dentistry in San Jose, CA
• Providers in San Jose, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.

Verify at the official NPI Registry.