Individual provider Active NPI

Yi-Ling Akiho Loo

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1265111454
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
018.002286 Issued in IL
Practice address
714 Tiverton Ave
Los Angeles, CA 90095-8361
Phone
(310) 206-3904
NPI assigned
Jul 14, 2023
Last updated
Jul 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 018.002286 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

714 Tiverton Ave
Los Angeles, CA 90095-8361

Mailing address

801 S Paulina St
Chicago, IL 60612-7210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20240730004474 IL Order and Referring Only - DentistPractitioner - DentistPractitioner - Pediatric Dentistry 1658818364

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
018.002286ILMDDentist

Interoperability endpoints

  • Direct secure messaging: yloo171423@uihealth.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1689292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1265111454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S PAULINA ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 TIVERTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900958361",
            "telephone_number": "310-206-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOO",
        "first_name": "YI-LING",
        "middle_name": "AKIHO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-14",
        "last_updated": "2024-07-17",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "018.002286",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.