Active NPI
Lucia Raduca, DDS
- General Practice Dentistry
- Los Angeles, CA
National Provider Identifier
1316057052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 40297
- Practice address
- 11373 Washington Blvd
#B
Los Angeles, CA 90066 - Phone
- (310) 636-9292
- Fax
- (310) 636-0191
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 40297 | CA | Primary |
Addresses
Primary practice location
11373 Washington Blvd
#B
Los Angeles, CA 90066
Mailing address
11373 Washington Blvd
#B
Los Angeles, CA 90066
Phone (310) 636-9292
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| B4029702 | Other | CA | DENTI CAL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 40297 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1316057052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11373 WASHINGTON BLVD",
"address_2": "#B",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90066",
"telephone_number": "310-636-9292",
"fax_number": "310-636-0191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11373 WASHINGTON BLVD",
"address_2": "#B",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90066",
"telephone_number": "310-636-9292",
"fax_number": "310-636-0191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RADUCA",
"first_name": "LUCIA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "40297",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTI CAL",
"identifier": "B4029702",
"state": "CA"
}
],
"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 Jul 8, 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.