Mamta Pooran Dalwani

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

51571 Issued in CA

Practice address

12381 Wilshire Blvd Ste 103
Los Angeles, CA 90025-1063

Phone

(310) 207-4617

NPI assigned

May 8, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Mamta Pooran Dalwani Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Pooran Dalwani DDS Inc

  • Dentist
  • Inglewood, CA
  • NPI 1790918381
  NPD (past) Authorized official

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1124295241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12381 WILSHIRE BLVD STE 103",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251063",
            "telephone_number": "310-207-4617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12381 WILSHIRE BLVD STE 103",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251063",
            "telephone_number": "310-207-4617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALWANI",
        "first_name": "MAMTA",
        "middle_name": "POORAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-08",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "51571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAMTA",
            "last_name": "DALWANI",
            "middle_name": "POORAN",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Olya Dalrymple
• Barbara Dalton-Taylor, PH.D.
• Alexandra Dalton
• Samantha Dalton
• Pranav Bharat Dalvi
• Emily Daly
• Joanne R. Daly, MD
• Kaitlin Daly, M.A., LMFT 159554
• Kathleen A. Daly, M.D.
• Maria Frances Daly, D.O.

• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; 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.