Active NPI
Enrique Tamayo D.D.S., Inc.
- Dentist
- Los Angeles, CA
National Provider Identifier
1417868092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- Legal business name
- ENRIQUE TAMAYO D.D.S., INC.
- Practice address
- 4400 S Broadway Ste 103
Los Angeles, CA 90037-2792 - Phone
- (323) 233-9400
- Fax
- (323) 233-9977
- NPI assigned
- Sep 14, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Enrique Tamayo, D.D.S.
- Title
- Owner
- Phone
- (323) 233-9400
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | Primary |
Addresses
Primary practice location
4400 S Broadway Ste 103
Los Angeles, CA 90037-2792
Mailing address
4400 S Broadway Ste 103
Los Angeles, CA 90037-2792
Phone (323) 233-9400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 52474 | Other | CA | DENTAL BOARD OF CALIFORNIA |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
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.
-
- General Practice Dentistry
- Los Angeles, CA
- NPI 1811033699
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1789344000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1789344000000",
"number": "1417868092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4400 S BROADWAY STE 103",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900372792",
"telephone_number": "323-233-9400",
"fax_number": "323-233-9977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4400 S BROADWAY STE 103",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900372792",
"telephone_number": "323-233-9400",
"fax_number": "323-233-9977"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ENRIQUE TAMAYO D.D.S., INC.",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-14",
"last_updated": "2026-09-14",
"certification_date": "2026-09-14",
"status": "A",
"authorized_official_last_name": "TAMAYO",
"authorized_official_first_name": "ENRIQUE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "323-233-9400",
"authorized_official_credential": "D.D.S."
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL BOARD OF CALIFORNIA",
"identifier": "52474",
"state": "CA"
}
],
"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 Sep 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.