Active NPI
Michael E Ignacio, D.D.S.
- General Practice Dentistry
- Los Angeles, CA
National Provider Identifier
1205181179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 61450
- Practice address
- 1916 W. Colorado
Los Angeles, CA 90041 - Phone
- (323) 340-8014
- Fax
- (323) 340-8932
- NPI assigned
- Jul 17, 2012
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 61450 | CA | Primary |
Addresses
Primary practice location
1916 W. Colorado
Los Angeles, CA 90041
Mailing address
1009 E. Mountain Street
Glendale, CA 91207
Phone (818) 636-4057
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342483200000",
"number": "1205181179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1009 E. MOUNTAIN STREET",
"city": "GLENDALE",
"state": "CA",
"postal_code": "91207",
"telephone_number": "818-636-4057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1916 W. COLORADO",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90041",
"telephone_number": "323-340-8014",
"fax_number": "323-340-8932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IGNACIO",
"first_name": "MICHAEL",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-17",
"last_updated": "2012-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "61450",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.