Active NPI
Edna Loera, DMD
- Public Health Dentistry
- Fresno, CA
National Provider Identifier
1285399006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health Dentistry
- License
- 107080
- Practice address
- 1225 M St
Fresno, CA 93721-1805 - Phone
- (559) 600-8241
- NPI assigned
- Nov 5, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health Dentistry | 1223D0001X | 107080 | CA | Primary |
Addresses
Primary practice location
1225 M St
Fresno, CA 93721-1805
Mailing address
1962 Tamarack Ave
Sanger, CA 93657-2053
Phone (559) 618-1647
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221215003130 | CA | Order and Referring Only - Dentist | 7517336415 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636070400000",
"number": "1285399006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1962 TAMARACK AVE",
"city": "SANGER",
"state": "CA",
"postal_code": "936572053",
"telephone_number": "559-618-1647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 M ST",
"city": "FRESNO",
"state": "CA",
"postal_code": "937211805",
"telephone_number": "559-600-8241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOERA",
"first_name": "EDNA",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-11-05",
"last_updated": "2021-11-05",
"certification_date": "2021-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223D0001X",
"taxonomy_group": "",
"desc": "Dentist, Dental Public Health",
"state": "CA",
"license": "107080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; 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.