Individual provider Active NPI

Larissa Creado

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1265559520
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
45847 Issued in CA
Practice address
2829 S Grand Ave
Los Angeles, CA 90007-3304
Phone
(213) 744-3986
NPI assigned
Mar 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 45847 CA
General Practice Dentistry 1223G0001X 45847 CA Primary

Addresses

Primary practice location

2829 S Grand Ave
Los Angeles, CA 90007-3304

Mailing address

2829 S Grand Ave
Los Angeles, CA 90007-3304
Phone (213) 744-3986

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
I20220303001764 CA Practitioner - Dentist 4385038520 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Los AngelesGroup PAC ID 1850296534, 395 clinicians

Practice addresses (Care Compare)

1333 Chestnut Ave
Long Beach, CA 90813-2944
Phone (562) 753-2315

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles Current Accepting new patients
County of Los Angeles CurrentSince Nov 25, 2021 Accepting new patients
County of Los Angeles CurrentSince Nov 25, 2021 Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

1333 Chestnut Ave
Long Beach, CA 90813
Phone (562) 599-8601

2829 S Grand Ave
Los Angeles, CA 90007
Phone (213) 699-7000

Organizations & group practices 3

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": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1265559520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2829 S GRAND AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900073304",
            "telephone_number": "213-744-3986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2829 S GRAND AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900073304",
            "telephone_number": "213-744-3986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREADO",
        "first_name": "LARISSA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "45847",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "45847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.