Individual provider Active NPI

Olga Yepes, D.D.S.

  • General Practice Dentistry
  • Glendale, CA
National Provider Identifier
1083676837
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
42453 Issued in CA
Practice address
1217 S Central Ave
Glendale, CA 91204-2503
Phone
(818) 242-9595
Fax
(818) 242-9524
NPI assigned
Apr 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 42453 CA Primary

Addresses

Primary practice location

1217 S Central Ave
Glendale, CA 91204-2503

Mailing address

1217 S Central Ave
Glendale, CA 91204-2503
Phone (818) 242-9595

Other identifiers 1

IdentifierTypeStateIssuer
514989OtherCADENTI-CAL PROGRAM

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

LicenseStateTypeSpecialty
42453CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083676837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 S CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042503",
            "telephone_number": "818-242-9595",
            "fax_number": "818-242-9524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 S CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042503",
            "telephone_number": "818-242-9595",
            "fax_number": "818-242-9524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEPES",
        "first_name": "OLGA",
        "name_prefix": "Mrs.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "42453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL PROGRAM",
            "identifier": "514989",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.