Individual provider Active NPI

Rex Sayo Laurente, D.D.S.

  • General Practice Dentistry
  • Burbank, CA
National Provider Identifier
1104045814
Registry record updated Sep 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
50771 Issued in CA
Practice address
1056 W Alameda Ave
Burbank, CA 91506-2846
Phone
(818) 556-5000
NPI assigned
Apr 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2012

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 50771 CA Primary

Addresses

Primary practice location

1056 W Alameda Ave
Burbank, CA 91506-2846

Mailing address

1056 W Alameda Ave
Burbank, CA 91506-2846
Phone (818) 556-5000

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
I20170322000324 CA Order and Referring Only - DentistPractitioner - Dentist 1254616824

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50771CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Teresita R. Laurente, DDS, Inc Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348099200000",
    "number": "1104045814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1056 W ALAMEDA AVE",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915062846",
            "telephone_number": "818-556-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1056 W ALAMEDA AVE",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915062846",
            "telephone_number": "818-556-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURENTE",
        "first_name": "REX",
        "middle_name": "SAYO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2012-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.