Individual provider Active NPI

Cristine Zapanta

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1316132673
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
55288 Issued in CA
Practice address
2105 Beverly Blvd Ste 103
Los Angeles, CA 90057-2249
Phone
(213) 483-4600
Fax
(213) 483-4144
NPI assigned
Sep 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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 55288 CA Primary

Addresses

Primary practice location

2105 Beverly Blvd Ste 103
Los Angeles, CA 90057-2249

Mailing address

2105 Beverly Blvd Ste 103
Los Angeles, CA 90057-2249
Phone (213) 483-4600

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200707000490 CA Practitioner - Oral Surgery 6204005432

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Zapanta-Chavez, DDS, Inc. CurrentSince Apr 1, 2020 Accepting new patients
Cristine Zapanta PastSince May 14, 2023 Accepting new patients
Cristine Saldana Zapanta, DDS, Inc. General Practice PastSince Nov 16, 2021 Accepting new patients

Locations

24021 Alessandro Blvd
Ste A120
Moreno Valley, CA 92553
Phone (951) 242-3328

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Eternally Yours Hospice IncWest Covina, CA, CCN 751657 Hospice 5% Or Greater Direct Ownership Interest (100%)
Corporate Officer (100%)
Corporate Director (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Dec 1, 2013
Dec 1, 2013
Dec 1, 2013
Jul 28, 2011
Dec 1, 2013

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1316132673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 BEVERLY BLVD STE 103",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572249",
            "telephone_number": "213-483-4600",
            "fax_number": "213-483-4144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 BEVERLY BLVD STE 103",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572249",
            "telephone_number": "213-483-4600",
            "fax_number": "213-483-4144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAPANTA",
        "first_name": "CRISTINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-10",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.