Active NPI
Gabriel Delavara, D.D.S
- General Practice Dentistry
- Hacienda Heights, CA
National Provider Identifier
1194843888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 46468
- Practice address
- 2219 S Hacienda Blvd Ste 202
Hacienda Heights, CA 91745-4610 - Phone
- (626) 806-3925
- Fax
- (626) 369-0257
- NPI assigned
- Mar 27, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 46468 | CA | Primary |
Addresses
Primary practice location
2219 S Hacienda Blvd Ste 202
Hacienda Heights, CA 91745-4610
Mailing address
2219 S Hacienda Blvd Ste 202
Hacienda Heights, CA 91745-4610
Phone (626) 806-3925
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
| License | State | Type | Specialty |
|---|---|---|---|
| 46468 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Canyon Dental Inc. | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194843888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2219 S HACIENDA BLVD STE 202",
"city": "HACIENDA HEIGHTS",
"state": "CA",
"postal_code": "917454610",
"telephone_number": "626-806-3925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2219 S HACIENDA BLVD STE 202",
"city": "HACIENDA HEIGHTS",
"state": "CA",
"postal_code": "917454610",
"telephone_number": "626-806-3925",
"fax_number": "626-369-0257"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELAVARA",
"first_name": "GABRIEL",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "46468",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hacienda Heights, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.