Active NPI
Jesenia Camacho
- Dental Assistant
- Los Angeles, CA
National Provider Identifier
1235456823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- 02177895
- Practice address
- 1212 Wilshire Blvd
1111
Los Angeles, CA 90017-1902 - Phone
- (310) 820-9933
- NPI assigned
- Apr 22, 2010
- 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 |
|---|---|---|---|---|
| Dental Assistant | 126800000X | 02177895 | CA | Primary |
Addresses
Primary practice location
1212 Wilshire Blvd
1111
Los Angeles, CA 90017-1902
Mailing address
15120 Pioneer Blvd
Norwalk, CA 90650-6449
Phone (562) 440-8544
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 |
|---|---|---|---|
| 02177895 | CA | MD | Dental Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271894400000",
"number": "1235456823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15120 PIONEER BLVD",
"city": "NORWALK",
"state": "CA",
"postal_code": "906506449",
"telephone_number": "562-440-8544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1212 WILSHIRE BLVD",
"address_2": "1111",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900171902",
"telephone_number": "310-820-9933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMACHO",
"first_name": "JESENIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-22",
"last_updated": "2010-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "CA",
"license": "02177895",
"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 Apr 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.