Individual provider Active NPI

Han K Tak, D.D.S.

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1205987559
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
50000 Issued in CA
Practice address
607 W 6TH St
Los Angeles, CA 90017-3201
Phone
(213) 624-6482
Fax
(213) 924-9483
NPI assigned
Jan 15, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 50000 CA Primary

Addresses

Primary practice location

607 W 6TH St
Los Angeles, CA 90017-3201

Mailing address

607 W 6TH St
Los Angeles, CA 90017-3201
Phone (213) 624-6482

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150706000715 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0941512941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50000CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Han K.Tak,D.D.S. a Professional Corporation Past Accepting new patients
Jimmy Slamat, D.D.S., a Professional Corporation General Practice Past Accepting new patients

Organizations & group practices 2

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": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205987559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 W 6TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900173201",
            "telephone_number": "213-624-6482",
            "fax_number": "213-924-9483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 W 6TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900173201",
            "telephone_number": "213-624-6482",
            "fax_number": "213-924-9483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAK",
        "first_name": "HAN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.