Mobile Teeth Cleaning

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

HAP173 Issued in CA

Legal business name

MOBILE TEETH CLEANING

Practice address

3205 Los Feliz BL
13309
Los Angeles, CA 90039-1554

Phone

(323) 333-9938

Fax

(323) 446-7313

NPI assigned

Dec 28, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Aaron Benjamin Benitez, RDHAP

Title

Owner

Phone

(323) 333-9938

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Aaron Benitez, RDHAP Other name

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198800000000",
    "number": "1104000934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 LOS FELIZ BL",
            "address_2": "13309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900391554",
            "telephone_number": "323-333-9938",
            "fax_number": "323-446-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 LOS FELIZ BL",
            "address_2": "13309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900391554",
            "telephone_number": "323-333-9938",
            "fax_number": "323-446-7313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE TEETH CLEANING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-28",
        "last_updated": "2007-12-28",
        "status": "A",
        "authorized_official_last_name": "BENITEZ",
        "authorized_official_first_name": "AARON",
        "authorized_official_middle_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-333-9938",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RDHAP"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "HAP173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z8978301",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aaron Benitez, RDHAP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Dental Hygienist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dental Hygienist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.