Individual provider Active NPI

Tawny Richards-Coppola, DDS

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1356899470
Registry record updated Aug 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
105800 Issued in CA
Practice address
12756 W Washington Blvd
Los Angeles, CA 90066-2309
Phone
(310) 945-2416
NPI assigned
Sep 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2023

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 062926 NY
Dentist 122300000X 34545 TX
General Practice Dentistry 1223G0001X 105800 CA
General Practice Dentistry 1223G0001X 062926 NY
General Practice Dentistry 1223G0001X DN22270 FL
General Practice Dentistry 1223G0001X 34545 TX
Dentist 122300000X 105800 CA Primary

Addresses

Primary practice location

12756 W Washington Blvd
Los Angeles, CA 90066-2309

Mailing address

PO Box 462037
1125 N Fairfax Ave
West Hollywood, CA 90046-9998
Phone (424) 438-4998

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
105800CAMDClinical Social Worker
DN22270FLMDGeneral Practice Dentistry
062926NYMDGeneral Practice Dentistry
34545TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Tawny Richards, DDS, Inc. CurrentSince Aug 13, 2023 Accepting new patients

Locations

12756 W Washington Blvd
Los Angeles, CA 90066
Phone (310) 574-8574

1125 N Fairfax Ave
West Hollywood, CA 90046
Phone (305) 434-2424

Organizations & group practices 1

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": "1474243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691193600000",
    "number": "1356899470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 462037",
            "address_2": "1125 N FAIRFAX AVE",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900469998",
            "telephone_number": "424-438-4998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12756 W WASHINGTON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900662309",
            "telephone_number": "310-945-2416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDS-COPPOLA",
        "first_name": "TAWNY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-19",
        "last_updated": "2023-08-05",
        "certification_date": "2023-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "062926",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "34545",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "105800",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "062926",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN22270",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34545",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "105800",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 5, 2023; 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.