Organization Active NPI

Kayla Koo Dental Group, Inc

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1134827959
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
KAYLA KOO DENTAL GROUP, INC
Practice address
4214 Beverly Blvd Ste 209
Los Angeles, CA 90004-4429
Phone
(213) 675-1824
NPI assigned
Feb 21, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Authorized official

Name
Dr. Kayla Koo, DDSNPI 1942495510
Title
Ceo
Phone
(213) 675-1824

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
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

4214 Beverly Blvd Ste 209
Los Angeles, CA 90004-4429

Mailing address

4214 Beverly Blvd Ste 209
Los Angeles, CA 90004-4429
Phone (213) 675-1824

National Provider Directory

National Provider Directory

Locations

4214 Beverly Blvd
Ste 209
Los Angeles, CA 90004
Phone (213) 675-1824

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": "1676937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676937600000",
    "number": "1134827959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4214 BEVERLY BLVD STE 209",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900044429",
            "telephone_number": "213-675-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4214 BEVERLY BLVD STE 209",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900044429",
            "telephone_number": "213-675-1824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAYLA KOO DENTAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-21",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A",
        "authorized_official_last_name": "KOO",
        "authorized_official_first_name": "KAYLA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "213-675-1824",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 21, 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.