Individual provider Active NPI

Carla S Belgarde-Duru, DDS

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1356619324
Registry record updated Dec 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
60931 Issued in CA
Practice address
3756 Santa Rosalia Dr Ste 517
Los Angeles, CA 90008-3656
Phone
(323) 243-2117
NPI assigned
Dec 6, 2011
Last updated
Dec 6, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2011

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 60931 CA Primary

Addresses

Primary practice location

3756 Santa Rosalia Dr Ste 517
Los Angeles, CA 90008-3656

Mailing address

3756 Santa Rosalia Dr Ste 517
Los Angeles, CA 90008-3656
Phone (323) 243-2117

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
I20160415000293 CA Order and Referring Only - DentistPractitioner - Dentist 2567760176

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60931CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
CRL3 LLC Current Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1323129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323129600000",
    "number": "1356619324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3756 SANTA ROSALIA DR STE 517",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900083656",
            "telephone_number": "323-243-2117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3756 SANTA ROSALIA DR STE 517",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900083656",
            "telephone_number": "323-243-2117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELGARDE-DURU",
        "first_name": "CARLA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-06",
        "last_updated": "2011-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "60931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.