Individual provider Active NPI

Earl George Freymiller, DMD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Los Angeles, CA
National Provider Identifier
1154536845
Registry record updated Mar 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
SP139 Issued in CA
Practice address
10833 Le Conte Ave
Ao-156
Los Angeles, CA 90095-1668
Phone
(310) 825-0834
NPI assigned
May 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X SP 139 CA
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X SP139 CA Primary

Addresses

Primary practice location

10833 Le Conte Ave
Ao-156
Los Angeles, CA 90095-1668

Mailing address

5767 W Century Blvd
Suite 400
Los Angeles, CA 90045-5631
Phone (310) 825-0863

Other identifiers 1

IdentifierTypeStateIssuer
D00139MedicaidCA

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP 139CAMDOral and Maxillofacial Surgery (Dentist)

Interoperability endpoints

  • Direct secure messaging: efreymiller10925@direct.uclahealth.org

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1154536845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD",
            "address_2": "SUITE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-825-0863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE",
            "address_2": "AO-156",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900951668",
            "telephone_number": "310-825-0834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREYMILLER",
        "first_name": "EARL",
        "middle_name": "GEORGE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "SP 139",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CA",
            "license": "SP139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D00139",
            "state": "CA"
        }
    ],
    "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 Mar 26, 2013; 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.