Individual provider Active NPI

Lauren Tomiko Odono, D.D.S.

  • General Practice Dentistry
  • Montebello, CA
National Provider Identifier
1376892810
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
61780 Issued in CA
Practice address
3523 W Beverly Blvd.
Montebello, CA 90640-1540
Phone
(323) 721-7993
Fax
(323) 721-5571
NPI assigned
Aug 30, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DB-2025-0022 NM
Dentist 122300000X DB-2025-0022 NM
General Practice Dentistry 1223G0001X 61780 CA Primary

Addresses

Primary practice location

3523 W Beverly Blvd.
Montebello, CA 90640-1540

Mailing address

3523 W Beverly Blvd.
Montebello, CA 90640-1540
Phone (323) 721-7993

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
I20220922002273 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9739564006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DB-2025-0022NMMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1346284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1376892810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3523 W BEVERLY BLVD.",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906401540",
            "telephone_number": "323-721-7993",
            "fax_number": "323-721-5571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3523 W BEVERLY BLVD.",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906401540",
            "telephone_number": "323-721-7993",
            "fax_number": "323-721-5571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODONO",
        "first_name": "LAUREN",
        "middle_name": "TOMIKO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-30",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NM",
            "license": "DB-2025-0022",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DB-2025-0022",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "61780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montebello, CA

Sources for this page

Verify at the official NPI Registry.