NPIMap

Organization Active NPI

Paul B. Palmer D.D.S., Inc

Doing business as Culver Del Rey Dental Center

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1285736413
Registry record updated Jul 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
28603 Issued in CA
Legal business name
PAUL B. PALMER D.D.S., INC
Doing business as
Culver Del Rey Dental Center
Practice address
12202 W Washington BL
Los Angeles, CA 90066
Phone
(310) 915-9797
Fax
(310) 915-9739
NPI assigned
Sep 1, 2006
Last updated
Jul 9, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2013

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

Authorized official

Name
Dr. Paul B Palmer, DDSNPI 1700946753
Title
Owner
Phone
(310) 915-9797

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 28603 CA Primary

Addresses

Primary practice location

12202 W Washington BL
Los Angeles, CA 90066

Mailing address

12202 W Washington BL
Los Angeles, CA 90066
Phone (310) 915-9797

Other identifiers 1

IdentifierTypeStateIssuer
521657OtherCADENTICAL

Other names 1

  • Culver Del Rey Dental Center Doing business as

National Provider Directory

National Provider Directory

Locations

12202 W Washington Blvd
Los Angeles, CA 90066
Phone (310) 915-9797

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373328000000",
    "number": "1285736413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12202 W WASHINGTON BL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90066",
            "telephone_number": "310-915-9797",
            "fax_number": "310-915-9739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12202 W WASHINGTON BL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90066",
            "telephone_number": "310-915-9797",
            "fax_number": "310-915-9739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL B. PALMER D.D.S., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-01",
        "last_updated": "2013-07-09",
        "status": "A",
        "authorized_official_last_name": "PALMER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-915-9797",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "28603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTICAL",
            "identifier": "521657",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Culver Del Rey Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 9, 2013; 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.