Organization Active NPI

Enrique Tamayo D.D.S., Inc.

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1417868092
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
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

Updated by the provider on Sep 14, 2026

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

Authorized official

Name
Enrique Tamayo, D.D.S.NPI 1811033699
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)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
52474OtherCADENTAL BOARD OF CALIFORNIA

National Provider Directory

National Provider Directory

Practitioners & 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.

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.

Verify at the official NPI Registry.