Individual provider Active NPI

Laura Mota, DDS

  • Public Health Dentistry
  • Wilmington, CA
National Provider Identifier
1073296216
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
DDS111500 Issued in CA
Practice address
200 E Anaheim St
Wilmington, CA 90744-4516
Phone
(888) 311-6322
NPI assigned
Aug 14, 2023
Last updated
Sep 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X DDS111500 CA Primary

Addresses

Primary practice location

200 E Anaheim St
Wilmington, CA 90744-4516

Mailing address

200 E Anaheim St
Wilmington, CA 90744-4516

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
I20250916004714 CA Practitioner - Dentist 8729582432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12317 Saticoy St
North Hollywood, CA 91605-3029

2550 W Main St
Suite 301
Alhambra, CA 91801-7003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS111500CAMDPublic Health Dentist
111500CAMDPediatric Hematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Community Clinic CurrentSince Aug 3, 2025 Accepting new patients
Northeast Community Clinic CurrentSince Aug 3, 2025 Accepting new patients
Northeast Community Clinic Current Accepting new patients

Locations

2550 W Main St
Ste 301
Alhambra, CA 91801
Phone (626) 457-6900

1414 S Grand Ave
Ste 380
Los Angeles, CA 90015
Phone (213) 222-1300

200 E Anaheim St
Wilmington, CA 90744
Phone (310) 522-8700

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1073296216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E ANAHEIM ST",
            "city": "WILMINGTON",
            "state": "CA",
            "postal_code": "907444516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E ANAHEIM ST",
            "city": "WILMINGTON",
            "state": "CA",
            "postal_code": "907444516",
            "telephone_number": "888-311-6322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTA",
        "first_name": "LAURA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "CA",
            "license": "DDS111500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, CA

Sources for this page

Verify at the official NPI Registry.