Individual provider Active NPI

Leonora Imperial, D.D.S.

  • General Practice Dentistry
  • Turlock, CA
National Provider Identifier
1124272406
Registry record updated Nov 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
31478 Issued in CA
Practice address
2150 Colorado Ave
Turlock, CA 95382-2003
Phone
(209) 668-9442
Fax
(209) 668-2781
NPI assigned
Nov 12, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2008

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 31478 CA Primary

Addresses

Primary practice location

2150 Colorado Ave
Turlock, CA 95382-2003

Mailing address

2150 Colorado Ave
Turlock, CA 95382-2003
Phone (209) 668-9442

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
I20140829001226 CA Practitioner - Oral Surgery 8729206990 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31478CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Fulbright Dental Group, PC General Practice CurrentSince Dec 19, 2015 Accepting new patients

Locations

5220 Pacific Concourse Dr
Ste 120
Los Angeles, CA 90045
Phone (310) 228-0396

1801 W Olympic Blvd
#1738
Pasadena, CA 91199

7488 Shoreline Dr
Ste B4
Stockton, CA 95219
Phone (209) 475-9300

188 Frank West Cir
Ste G
Stockton, CA 95206
Phone (310) 337-1694

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": "1226448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226448000000",
    "number": "1124272406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 COLORADO AVE",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953822003",
            "telephone_number": "209-668-9442",
            "fax_number": "209-668-2781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 COLORADO AVE",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953822003",
            "telephone_number": "209-668-9442",
            "fax_number": "209-668-2781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMPERIAL",
        "first_name": "LEONORA",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-12",
        "last_updated": "2008-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "31478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Turlock, CA

Sources for this page

Verify at the official NPI Registry.