Organization Active NPI

RG Smiles

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1104500289
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
RG SMILES
Practice address
3033 Wilshire Blvd Unit Ph1606
Los Angeles, CA 90010-1000
Phone
(909) 510-3524
NPI assigned
Jun 9, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Authorized official

Name
Dr. Roselle Cabana LopezNPI 1194916452
Title
Ceo
Phone
(909) 510-3524

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

3033 Wilshire Blvd Unit Ph1606
Los Angeles, CA 90010-1000

Mailing address

3033 Wilshire Blvd Unit Ph1606
Los Angeles, CA 90010-1000

Other identifiers 1

IdentifierTypeStateIssuer
1194916452OtherCANPI TYPE 1

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1686268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696809600000",
    "number": "1104500289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 WILSHIRE BLVD UNIT PH1606",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900101000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 WILSHIRE BLVD UNIT PH1606",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900101000",
            "telephone_number": "909-510-3524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RG SMILES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-09",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "ROSELLE",
        "authorized_official_middle_name": "CABANA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-510-3524",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1194916452",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; 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.