Individual provider Active NPI

Alyssa Nga Du, D.M.D

  • General Practice Dentistry
  • Redondo Beach, CA
National Provider Identifier
1295915239
Registry record updated Nov 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
44165 Issued in CA
Practice address
1704 Perkins LN
Redondo Beach, CA 90278-3903
Phone
(310) 704-6553
NPI assigned
Nov 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 44165 CA Primary

Addresses

Primary practice location

1704 Perkins LN
Redondo Beach, CA 90278-3903

Mailing address

1704 Perkins LN
Redondo Beach, CA 90278-3903
Phone (310) 704-6553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
44165CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194393600000",
    "number": "1295915239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 PERKINS LN",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902783903",
            "telephone_number": "310-704-6553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 PERKINS LN",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902783903",
            "telephone_number": "310-704-6553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DU",
        "first_name": "ALYSSA",
        "middle_name": "NGA",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-07",
        "last_updated": "2007-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "44165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.