Active NPI
Yolanda S Cervantes, DMD
- Dentist
- Carson, CA
National Provider Identifier
1104093764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 36614
- Practice address
- 208 E Carson St
Suite 200
Carson, CA 90745-2700 - Phone
- (310) 830-2624
- Fax
- (310) 830-4464
- NPI assigned
- May 13, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 36614 | CA | Primary |
Addresses
Primary practice location
208 E Carson St
Suite 200
Carson, CA 90745-2700
Mailing address
208 E Carson St
Suite 200
Carson, CA 90745-2700
Phone (310) 830-2624
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 632697 | Other | PA | UNITED CONCORDIA |
| 701465 | Other | CA | CDHP |
| G90616 | Other | CA | DENTICAL |
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 |
|---|---|---|---|
| 36614 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yolanda S Cervantes DMD, 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.
-
- General Practice Dentistry
- Carson, CA
- NPI 1487694840
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210636800000",
"number": "1104093764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "208 E CARSON ST",
"address_2": "SUITE 200",
"city": "CARSON",
"state": "CA",
"postal_code": "907452700",
"telephone_number": "310-830-2624",
"fax_number": "310-830-4464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 E CARSON ST",
"address_2": "SUITE 200",
"city": "CARSON",
"state": "CA",
"postal_code": "907452700",
"telephone_number": "310-830-2624",
"fax_number": "310-830-4464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CERVANTES",
"first_name": "YOLANDA",
"middle_name": "S",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-13",
"last_updated": "2008-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "36614",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "632697",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDHP",
"identifier": "701465",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTICAL",
"identifier": "G90616",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Carson, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.