Individual provider Active NPI

Bertha Olivia Alarcon-Vargas, D.D.S

  • General Practice Dentistry
  • Cudahy, CA
National Provider Identifier
1073570248
Registry record updated Dec 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
38245 Issued in CA
Practice address
4566 Florence Ave
Suite 7
Cudahy, CA 90201-4345
Phone
(323) 560-7474
Fax
(323) 560-0424
NPI assigned
Apr 29, 2006
Last updated
Dec 15, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2014

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 38245 CA Primary

Addresses

Primary practice location

4566 Florence Ave
Suite 7
Cudahy, CA 90201-4345

Mailing address

4566 Florence Ave
Suite 7
Cudahy, CA 90201-4345
Phone (323) 560-7474

Other identifiers 1

IdentifierTypeStateIssuer
B38245-01MedicaidCA

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
I20150709001846 CA Order and Referring Only - DentistPractitioner - Dentist 2860704475

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1146268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418601600000",
    "number": "1073570248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4566 FLORENCE AVE",
            "address_2": "SUITE 7",
            "city": "CUDAHY",
            "state": "CA",
            "postal_code": "902014345",
            "telephone_number": "323-560-7474",
            "fax_number": "323-560-0424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4566 FLORENCE AVE",
            "address_2": "SUITE 7",
            "city": "CUDAHY",
            "state": "CA",
            "postal_code": "902014345",
            "telephone_number": "323-560-7474",
            "fax_number": "323-560-0424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALARCON-VARGAS",
        "first_name": "BERTHA",
        "middle_name": "OLIVIA",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-29",
        "last_updated": "2014-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "38245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B38245-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cudahy, CA

Sources for this page

Verify at the official NPI Registry.