Individual provider Active NPI

Michelle Avila Pimentel

  • Dental Assistant
  • Rolling Hills Estates, CA
National Provider Identifier
1114872520
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AssistantTaxonomy code 126800000X
License
103945 Issued in CA
Practice address
550 Deep Valley Dr Ste 345
Rolling Hills Estates, CA 90274-7603
Phone
(310) 377-4551
NPI assigned
Mar 2, 2026
Last updated
Mar 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Assistant 126800000X 103945 CA Primary

Addresses

Primary practice location

550 Deep Valley Dr Ste 345
Rolling Hills Estates, CA 90274-7603

Mailing address

6366 Gotham St
Bell Gardens, CA 90201-5622
Phone (562) 641-1784

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

LicenseStateTypeSpecialty
103945CAMDDental Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jonathan Lo D.D.S., 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1772409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1114872520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6366 GOTHAM ST",
            "city": "BELL GARDENS",
            "state": "CA",
            "postal_code": "902015622",
            "telephone_number": "562-641-1784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 DEEP VALLEY DR STE 345",
            "city": "ROLLING HILLS ESTATES",
            "state": "CA",
            "postal_code": "902747603",
            "telephone_number": "310-377-4551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILA PIMENTEL",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-02",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "CA",
            "license": "103945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolling Hills Estates, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2026; 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.