Individual provider Active NPI

Paula Elmi, DMD

  • Endodontics
  • Diamond Bar, CA
National Provider Identifier
1245458249
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
54935 Issued in CA
Practice address
750 N Diamond Bar Blvd Ste 112
Diamond Bar, CA 91765-1023
Phone
(626) 802-5079
NPI assigned
Apr 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 54935 CA Primary

Addresses

Primary practice location

750 N Diamond Bar Blvd Ste 112
Diamond Bar, CA 91765-1023

Mailing address

15902A Halliburton Rd
#812
Hacienda Heights, CA 91745-3505
Phone (626) 802-5079

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
I20160726000780 CA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 7810280088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Paula G. Elmi, DMD, Apc Endodontics CurrentSince Feb 23, 2020 Accepting new patients
Reid V. Pullen, D.D.S., P.C. Endodontics Past Accepting new patients

Locations

750 N Diamond Bar Blvd
Ste 112
Diamond Bar, CA 91765
Phone (626) 802-5079

15902 Halliburton Rd
Ste A
Hacienda Heights, CA 91745
Phone (949) 542-2658

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1245458249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15902A HALLIBURTON RD",
            "address_2": "#812",
            "city": "HACIENDA HEIGHTS",
            "state": "CA",
            "postal_code": "917453505",
            "telephone_number": "626-802-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 N DIAMOND BAR BLVD STE 112",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917651023",
            "telephone_number": "626-802-5079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMI",
        "first_name": "PAULA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "54935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Diamond Bar, CA

Sources for this page

Verify at the official NPI Registry.