Hyacinth Ezebilo Ezeani, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

39398 Issued in CA

Practice address

20763 Avalon Blvd
Carson, CA 90746-3313

Phone

(310) 719-1865

NPI assigned

Jul 30, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ezeani DDS Dental Corp

  • Dentist
  • Carson, CA
  • NPI 1689896458

  CA, Dentist

  Medicare reassignment NPD Authorized official
• Nikzad Nafisi Dental Corp

  • Dentist
  • Los Angeles, CA
  • NPI 1851714125
  NPD (past)
• Park Professional Dental Corp

  • Dentist
  • Los Angeles, CA
  • NPI 1386135671
  NPD (past)

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428451200000",
    "number": "1104016765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W MANCHESTER AVE STE 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900445700",
            "telephone_number": "323-750-1582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20763 AVALON BLVD",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907463313",
            "telephone_number": "310-719-1865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZEANI",
        "first_name": "HYACINTH",
        "middle_name": "EZEBILO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-30",
        "last_updated": "2015-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "39398",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "39398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Exos - Athletes' Performance Los Angeles LLC
• Eyesmile Optometry, Inc
• Ijeoma Eze
• Pascal Eze
• Ezeani DDS Dental Corp
• Ifeoma Lawretta Ezeani, OD
• Joann Nneka Ezeibe, RN, BSN
• Uzodinma Ezeibekwe
• Maria Fabian, RPT
• Alma Nartatez Fabro, FNP

• All providers in Carson, CA
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.