NPIMap

Organization Active NPI

Hartanto L. Justin D.D.S. , Inc

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1427104488
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
39019 Issued in CA
Legal business name
HARTANTO L. JUSTIN D.D.S. , INC
Practice address
3231 N Broadway
Los Angeles, CA 90031-2801
Phone
(323) 221-6090
NPI assigned
Jan 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Hartanto Lawrence Justin, D.D.SNPI 1205982311
Title
President
Phone
(323) 221-6090

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 39019 CA Primary

Addresses

Primary practice location

3231 N Broadway
Los Angeles, CA 90031-2801

Mailing address

3231 N Broadway
Los Angeles, CA 90031-2801
Phone (323) 221-6090

National Provider Directory

National Provider Directory

Locations

3231 N Broadway
Los Angeles, CA 90031
Phone (323) 221-6090

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427104488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3231 N BROADWAY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900312801",
            "telephone_number": "323-221-6090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3231 N BROADWAY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900312801",
            "telephone_number": "323-221-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARTANTO L. JUSTIN D.D.S. , INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JUSTIN",
        "authorized_official_first_name": "HARTANTO",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-221-6090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "39019",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 22, 2020; 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.