Dr. Susan S. Gomez-Baba

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

36545 Issued in CA

Legal business name

DR. SUSAN S. GOMEZ-BABA

Practice address

330 N Vermont Ave
Los Angeles, CA 90004-3511

Phone

(323) 660-8778

Fax

(323) 660-8779

NPI assigned

Oct 1, 2009

Last updated

Oct 1, 2009By the provider in NPPES

Organization subpart

Yes

Parent organization

SUSAN S. GOMEZ-BABA, DMDAs reported in NPPES

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

Authorized official

Name

Dr. Susan S Gomez-BabaNPI 1568679280

Title

Dentist/Owner

Phone

(323) 660-8778

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Dr Susan S Gomez-Baba

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.

• Susan Sia Gomez-Baba, DDS

  • General Practice Dentistry
  • Los Angeles, CA
  • NPI 1568679280
  NPD (past) Authorized official

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

{
    "created_epoch": "1254355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254355200000",
    "number": "1235463688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900043511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900043511",
            "telephone_number": "323-660-8778",
            "fax_number": "323-660-8779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. SUSAN S. GOMEZ-BABA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUSAN S. GOMEZ-BABA, DMD",
        "enumeration_date": "2009-10-01",
        "last_updated": "2009-10-01",
        "status": "A",
        "authorized_official_last_name": "GOMEZ-BABA",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "323-660-8778",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "36545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "B36545-02",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2009; 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.