NPIMap

Organization Active NPI

Nick a. Agpalo, D.M.D., Inc.

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1265615553
Registry record updated Dec 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
32257 Issued in CA
Legal business name
NICK A. AGPALO, D.M.D., INC.
Practice address
4210 Eagle Rock Blvd
Los Angeles, CA 90065-4405
Phone
(323) 550-8341
NPI assigned
Dec 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2007

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

Authorized official

Name
Nick A. AgpaloNPI 1659492171
Title
Owner/Dental
Phone
(323) 550-8341

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 32257 CA Primary

Addresses

Primary practice location

4210 Eagle Rock Blvd
Los Angeles, CA 90065-4405

Mailing address

4210 Eagle Rock Blvd
Los Angeles, CA 90065-4405
Phone (323) 550-8341

National Provider Directory

National Provider Directory

Locations

4210 Eagle Rock Blvd
Los Angeles, CA 90065
Phone (323) 550-8341

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197244800000",
    "number": "1265615553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4210 EAGLE ROCK BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900654405",
            "telephone_number": "323-550-8341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210 EAGLE ROCK BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900654405",
            "telephone_number": "323-550-8341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICK A. AGPALO, D.M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-10",
        "last_updated": "2007-12-10",
        "status": "A",
        "authorized_official_last_name": "AGPALO",
        "authorized_official_first_name": "NICK",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER/DENTAL",
        "authorized_official_telephone_number": "323-550-8341"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "32257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2007; 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.