Individual provider Active NPI

Cheryl Diane Bingham, DDS

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1194792218
Registry record updated Apr 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
034818 Issued in CA
Practice address
11905 S Central Ave
#203
Los Angeles, CA 90059-2836
Phone
(323) 564-7504
Fax
(323) 564-8645
NPI assigned
Mar 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2012

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 034818 CA Primary

Addresses

Primary practice location

11905 S Central Ave
#203
Los Angeles, CA 90059-2836

Mailing address

11905 S Central Ave
#203
Los Angeles, CA 90059-2836
Phone (323) 564-7504

Other identifiers 1

IdentifierTypeStateIssuer
B34818MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160801002486 PA Order and Referring Only - DentistPractitioner - Dentist 0941593719

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
034818CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334102400000",
    "number": "1194792218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11905 S CENTRAL AVE",
            "address_2": "#203",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900592836",
            "telephone_number": "323-564-7504",
            "fax_number": "323-564-8645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11905 S CENTRAL AVE",
            "address_2": "#203",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900592836",
            "telephone_number": "323-564-7504",
            "fax_number": "323-564-8645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BINGHAM",
        "first_name": "CHERYL",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-07",
        "last_updated": "2012-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "034818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B34818",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.