Active NPI
Dina Kikue Brent, MD
- Pediatrics Physician
- Los Angeles, CA
National Provider Identifier
1194983825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- G46412
- Practice address
- 1625 E 4TH St
Los Angeles, CA 90033-4201 - Phone
- (213) 893-1960
- Fax
- (213) 229-9061
- NPI assigned
- May 29, 2008
- Last updated
- May 29, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | G46412 | CA | Primary |
Addresses
Primary practice location
1625 E 4TH St
Los Angeles, CA 90033-4201
Mailing address
311 Winston St
Los Angeles, CA 90013-1519
Phone (213) 893-1960
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110615000444 | CA | Order and Referring Only - Pediatric Medicine | 6204882731 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G46412 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212019200000",
"number": "1194983825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 WINSTON ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900131519",
"telephone_number": "213-893-1960",
"fax_number": "213-893-1967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1625 E 4TH ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900334201",
"telephone_number": "213-893-1960",
"fax_number": "213-229-9061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENT",
"first_name": "DINA",
"middle_name": "KIKUE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-29",
"last_updated": "2008-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "G46412",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
- Revital Brenner
- Ryann Brenner
- William Irwin Brenner, M.D.
- Brent-Air Pharmacy Inc (Brent Air Pharmacy)
- Aliya Nicole Brent
- Gregory Alan Brent, MD
- Timothy Brent
- Linden Brentano
- Brentview Medical Inc. (Brentview Medical Urgent Care)
- Brentwood - Eating Disorder Center of California, LLC (Eating Disorder Center of California)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.