Active NPI
Stephanie Lynn Estrada, RDH
- Dental Hygienist
- Gardena, CA
National Provider Identifier
1083194948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 24060
- Practice address
- 14885 Sutro Ave
Gardena, CA 90249-3640 - Phone
- (310) 721-3329
- NPI assigned
- Aug 20, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 24060 | CA | Primary |
Addresses
Primary practice location
14885 Sutro Ave
Gardena, CA 90249-3640
Mailing address
14885 Sutro Ave
Gardena, CA 90249-3640
Phone (310) 721-3329
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24060 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534723200000",
"number": "1083194948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14885 SUTRO AVE",
"city": "GARDENA",
"state": "CA",
"postal_code": "902493640",
"telephone_number": "310-721-3329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14885 SUTRO AVE",
"city": "GARDENA",
"state": "CA",
"postal_code": "902493640",
"telephone_number": "310-721-3329"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESTRADA",
"first_name": "STEPHANIE",
"middle_name": "LYNN",
"credential": "RDH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-20",
"last_updated": "2018-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dental Hygienist",
"state": "CA",
"license": "24060",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gardena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.