Individual provider Active NPI

Alma Evelia Velasquez, RDA

  • Dental Assistant
  • Baldwin Park, CA
National Provider Identifier
1366094112
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AssistantTaxonomy code 126800000X
License
RDA56826 Issued in CA
Practice address
4000 La Rica Ave Ste D
Baldwin Park, CA 91706-3163
Phone
(626) 430-9171
NPI assigned
Jul 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Assistant 126800000X RDA56826 CA Primary

Addresses

Primary practice location

4000 La Rica Ave Ste D
Baldwin Park, CA 91706-3163

Mailing address

3755 La Madera Ave
El Monte, CA 91732-2321

Other identifiers 1

IdentifierTypeStateIssuer
RDA5686MedicaidCA

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
RDA56826CAMDDental Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cohen Sedgh, Manavi & Pakravan Dental Corporation Past Accepting new patients
Ryan Sein Chein Lee DDS Inc Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1366094112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3755 LA MADERA AVE",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917322321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 LA RICA AVE STE D",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917063163",
            "telephone_number": "626-430-9171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASQUEZ",
        "first_name": "ALMA",
        "middle_name": "EVELIA",
        "credential": "RDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "CA",
            "license": "RDA56826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RDA5686",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baldwin Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2019; 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.