Active NPI
Beatriz Lara
- Dentist
- Philadelphia, PA
National Provider Identifier
1245081447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS044801
- Practice address
- 1500 John F Kennedy Blvd Ste 1906
Philadelphia, PA 19102-1714 - Phone
- (267) 322-2792
- NPI assigned
- Mar 27, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | DS044801 | PA | Primary |
Addresses
Primary practice location
1500 John F Kennedy Blvd Ste 1906
Philadelphia, PA 19102-1714
Mailing address
1200 Old York Rd
Abington, PA 19001-3788
Phone (215) 481-2000
Other practice location 1
1200 Old York Rd
Abington, PA 19001-3788
Phone (215) 481-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240805002899 | PA | Order and Referring Only - Dentist | 7719424035 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS044801 | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747180800000",
"number": "1245081447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 OLD YORK RD",
"city": "ABINGTON",
"state": "PA",
"postal_code": "190013788",
"telephone_number": "215-481-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 JOHN F KENNEDY BLVD STE 1906",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191021714",
"telephone_number": "267-322-2792"
}
],
"practiceLocations": [
{
"address_1": "1200 Old York Rd",
"address_purpose": "LOCATION",
"city": "Abington",
"state": "PA",
"postal_code": "190013788",
"country_code": "US",
"telephone_number": "215-481-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LARA",
"first_name": "BEATRIZ",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-27",
"last_updated": "2025-05-14",
"certification_date": "2025-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS044801",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.