NPIMap

Organization Active NPI

Oates and Jefferson Dental Corporation

Doing business as Hermosa Smiles Dentistry

  • General Practice Dentistry
  • Hermosa Beach, CA
National Provider Identifier
1174961536
Registry record updated Jun 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
OATES AND JEFFERSON DENTAL CORPORATION
Doing business as
Hermosa Smiles Dentistry
Practice address
1559 Pacific Coast Hwy
Suite 101
Hermosa Beach, CA 90254-3214
Phone
(310) 372-7686
Fax
(310) 372-7692
NPI assigned
Jun 7, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2013

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

Authorized official

Name
Dr. Walter Jefferson, DDS
Title
Owner
Phone
(310) 372-7686

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1559 Pacific Coast Hwy
Suite 101
Hermosa Beach, CA 90254-3214

Mailing address

17000 Red Hill Ave
Irvine, CA 92614-5626
Phone (714) 845-8890

Other names 1

  • Hermosa Smiles Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

1559 Pacific Coast Hwy
Ste 101
Hermosa Beach, CA 90254
Phone (310) 372-7686

Practitioners & affiliated clinicians

Practitioners 6

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": "1370563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370563200000",
    "number": "1174961536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1559 PACIFIC COAST HWY",
            "address_2": "SUITE 101",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902543214",
            "telephone_number": "310-372-7686",
            "fax_number": "310-372-7692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OATES AND JEFFERSON DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-07",
        "last_updated": "2013-06-07",
        "status": "A",
        "authorized_official_last_name": "JEFFERSON",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-372-7686",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hermosa Smiles Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hermosa Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.