Organization Active NPI

Annabella B Chu DMD Inc

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1164656187
Registry record updated May 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
50742 Issued in CA
Legal business name
ANNABELLA B CHU DMD INC
Practice address
2105 Beverly Blvd
Ste. 215
Los Angeles, CA 90057-2216
Phone
(213) 413-4444
Fax
(213) 413-2247
NPI assigned
May 5, 2009
Last updated
May 5, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2009

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

Authorized official

Name
Miss Annabella B Chu, DMD
Title
Dentist/Owner
Phone
(213) 413-4444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 50742 CA Primary

Addresses

Primary practice location

2105 Beverly Blvd
Ste. 215
Los Angeles, CA 90057-2216

Mailing address

2105 Beverly Blvd
Ste. 215
Los Angeles, CA 90057-2216
Phone (213) 413-4444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181212002008 CA Part B Supplier - Clinic/Group Practice 9436494820 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

2105 Beverly Blvd
Ste 215
Los Angeles, CA 90057
Phone (213) 413-4444

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241481600000",
    "number": "1164656187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 BEVERLY BLVD",
            "address_2": "STE. 215",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572216",
            "telephone_number": "213-413-4444",
            "fax_number": "213-413-2247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 BEVERLY BLVD",
            "address_2": "STE. 215",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572216",
            "telephone_number": "213-413-4444",
            "fax_number": "213-413-2247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNABELLA B CHU DMD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-05",
        "last_updated": "2009-05-05",
        "status": "A",
        "authorized_official_last_name": "CHU",
        "authorized_official_first_name": "ANNABELLA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "213-413-4444",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50742",
            "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 May 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.