Edwin Barzallo, DDS, Inc.

Primary specialty

DentistTaxonomy code 122300000X

License

49467 Issued in CA

Legal business name

EDWIN BARZALLO, DDS, INC.

Practice address

741 S Atlantic Blvd
Los Angeles, CA 90022-3213

Phone

(323) 263-3300

Fax

(323) 263-3400

NPI assigned

Apr 18, 2008

Last updated

Apr 18, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Edwin O Barzallo, D.D.S.NPI 1952575029

Title

Owner

Phone

(323) 263-3300

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Edwin O Barzallo, D.D.S.

  • Dentist
  • Los Angeles, CA
  • NPI 1952575029
  NPD (past) Authorized official

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

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208476800000",
    "number": "1205000387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 S ATLANTIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900223213",
            "telephone_number": "323-263-3300",
            "fax_number": "323-263-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 S ATLANTIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900223213",
            "telephone_number": "323-263-3300",
            "fax_number": "323-263-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWIN BARZALLO, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-18",
        "last_updated": "2008-04-18",
        "status": "A",
        "authorized_official_last_name": "BARZALLO",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-263-3300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "49467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G9240601",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terry Bernard Edwards, LMSW
• Thomas Walter Edwards Jr., D.D.S.
• Wendy Edwards, LCSW
• Edwin a Lee MD a Medical Corporation
• Edwin Baktanian, M.D., Apc
• Edwin Gromis M.D. a Prof Corp
• Edwin Jacobson M.D. Inc
• Edwin Kwon MD Inc
• Edwin M. Ashley Inc.
• Edwin Matias, M.D., a Professional Corporation

• Dentist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; 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.