Individual provider Active NPI

Fabiola A Lara, D.D.S.

  • General Practice Dentistry
  • San Francisco, CA
National Provider Identifier
1124296884
Registry record updated Feb 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
56654 Issued in CA
Practice address
450 Sutter St
#1620
San Francisco, CA 94108-4206
Phone
(415) 986-4556
Fax
(415) 986-4610
NPI assigned
Feb 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 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 56654 CA Primary

Addresses

Primary practice location

450 Sutter St
#1620
San Francisco, CA 94108-4206

Mailing address

450 Sutter St
#1620
San Francisco, CA 94108-4206
Phone (415) 986-4556

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
56654CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lara-Gimaldi Dental Current 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.

NPI Registry JSON

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203033600000",
    "number": "1124296884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 SUTTER ST",
            "address_2": "#1620",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941084206",
            "telephone_number": "415-986-4556",
            "fax_number": "415-986-4610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 SUTTER ST",
            "address_2": "#1620",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941084206",
            "telephone_number": "415-986-4556",
            "fax_number": "415-986-4610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARA",
        "first_name": "FABIOLA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-15",
        "last_updated": "2008-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "56654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.

Verify at the official NPI Registry.