Elizabeth Garcia, DDS Prof. Dental Corp.

Primary specialty

DentistTaxonomy code 122300000X

License

#47078 Issued in CA

Legal business name

ELIZABETH GARCIA, DDS PROF. DENTAL CORP.

Practice address

4170 Tweedy Blvd
South Gate, CA 90280-6147

Phone

(323) 564-1745

Fax

(323) 564-1779

NPI assigned

Mar 8, 2010

Last updated

Mar 8, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Elizabeth Garcia, DDSNPI 1831152453

Title

President/Dentist Owner

Phone

(323) 564-1745

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Elizabeth Garcia, DDS

  • Dentist
  • South Gate, CA
  • NPI 1831152453
  NPD (past) Authorized official

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

{
    "created_epoch": "1268006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268006400000",
    "number": "1407179369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4170 TWEEDY BLVD",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902806147",
            "telephone_number": "323-564-1745",
            "fax_number": "323-564-1779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4170 TWEEDY BLVD",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902806147",
            "telephone_number": "323-564-1745",
            "fax_number": "323-564-1779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH GARCIA, DDS PROF. DENTAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-08",
        "last_updated": "2010-03-08",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "PRESIDENT/DENTIST OWNER",
        "authorized_official_telephone_number": "323-564-1745",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "#47078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B47078",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Emile G. Shenouda MD, Inc
• Daniel Enayati, M.D.

• Dentist in South Gate, CA
• Providers in South Gate, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2010; 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.