Individual provider Active NPI

James Craig Serles, DDS

  • General Practice Dentistry
  • Long Beach, CA
National Provider Identifier
1164615480
Registry record updated Aug 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20463 Issued in CA
Practice address
4301 Atlantic Ave
Suite #4
Long Beach, CA 90807-2833
Phone
(562) 426-9308
Fax
(562) 426-9300
NPI assigned
Aug 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2007

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 20463 CA Primary

Addresses

Primary practice location

4301 Atlantic Ave
Suite #4
Long Beach, CA 90807-2833

Mailing address

4301 Atlantic Ave
Suite #4
Long Beach, CA 90807-2833
Phone (562) 426-9308

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
20463CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ezydental General Practice Past 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": "1187654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187654400000",
    "number": "1164615480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 ATLANTIC AVE",
            "address_2": "SUITE #4",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908072833",
            "telephone_number": "562-426-9308",
            "fax_number": "562-426-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 ATLANTIC AVE",
            "address_2": "SUITE #4",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908072833",
            "telephone_number": "562-426-9308",
            "fax_number": "562-426-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERLES",
        "first_name": "JAMES",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-21",
        "last_updated": "2007-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "20463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; 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.