Organization Active NPI

Lili Mirtorabi D.D.S a Professional Corporation

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Los Angeles, CA
National Provider Identifier
1053895565
Registry record updated Feb 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
LILI MIRTORABI D.D.S A PROFESSIONAL CORPORATION
Practice address
2368 Pico Boulevard
Los Angeles, CA 90006
Phone
(844) 347-5794
NPI assigned
Sep 20, 2018
Organization subpart
Yes
Parent organization
LILI MIRTORABI, D.D.S., M.S., A PROFESSIONAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 8, 2019

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

Authorized official

Name
Gabriela Valdovinos
Title
Managing Director
Phone
(323) 228-9282

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

2368 Pico Boulevard
Los Angeles, CA 90006

Mailing address

7722 Seville Ave
Huntington Park, CA 90255-6316
Phone (844) 347-5794

Other identifiers 1

IdentifierTypeStateIssuer
020669521OtherCAORTHODONTIST

National Provider Directory

National Provider Directory
Tax ID family
Lili Mirtorabi DDS a Professional Corporation2 organizations share this tax ID, including this one
Part of
Lili Mirtorabi DDS a Professional Corporation

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2368 W Pico Blvd
Los Angeles, CA 90006
Phone (844) 347-5794

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549584000000",
    "number": "1053895565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7722 SEVILLE AVE",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902556316",
            "telephone_number": "844-347-5794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2368 PICO BOULEVARD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90006",
            "telephone_number": "844-347-5794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LILI MIRTORABI D.D.S A PROFESSIONAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LILI MIRTORABI, D.D.S., M.S., A PROFESSIONAL CORPORATION",
        "enumeration_date": "2018-09-20",
        "last_updated": "2019-02-08",
        "status": "A",
        "authorized_official_last_name": "VALDOVINOS",
        "authorized_official_first_name": "GABRIELA",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "323-228-9282"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORTHODONTIST",
            "identifier": "020669521",
            "state": "CA"
        }
    ],
    "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 Feb 8, 2019; 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.