Active NPI
Sergio Machado Sr.
- Dental Assistant
- South Gate, CA
National Provider Identifier
1396111993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- 58435
- Practice address
- 4149 Tweedy Blvd
Suite J
South Gate, CA 90280-6167 - Phone
- (323) 807-7404
- NPI assigned
- Aug 18, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | 58435 | CA | Primary |
Addresses
Primary practice location
4149 Tweedy Blvd
Suite J
South Gate, CA 90280-6167
Mailing address
8442 San Luis Sve
South Gate, CA 90280
Phone (333) 807-7404
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
| License | State | Type | Specialty |
|---|---|---|---|
| 58435 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439856000000",
"number": "1396111993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8442 SAN LUIS SVE",
"city": "SOUTH GATE",
"state": "CA",
"postal_code": "90280",
"telephone_number": "333-807-7404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4149 TWEEDY BLVD",
"address_2": "SUITE J",
"city": "SOUTH GATE",
"state": "CA",
"postal_code": "902806167",
"telephone_number": "323-807-7404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACHADO",
"first_name": "SERGIO",
"name_suffix": "Sr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-18",
"last_updated": "2015-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "CA",
"license": "58435",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Gate, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.