Individual provider Active NPI

Gabriela Elizabeth Garcia, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Beaumont, CA
National Provider Identifier
1447569595
Registry record updated Apr 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
59959 Issued in CA
Practice address
11188 Runyan Rd
Beaumont, CA 92223-6209
Phone
(909) 809-9523
Fax
(951) 769-8998
NPI assigned
Oct 6, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 59959 CA Primary

Addresses

Primary practice location

11188 Runyan Rd
Beaumont, CA 92223-6209

Mailing address

11188 Runyan Rd
Beaumont, CA 92223-6209
Phone (909) 809-9523

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150826000375 CA Order and Referring Only - DentistPractitioner - Dentist 2466768171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: ggarcia71817@direct.llu.edu

NPI Registry JSON

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

{
    "created_epoch": "1286323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303084800000",
    "number": "1447569595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11188 RUNYAN RD",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922236209",
            "telephone_number": "909-809-9523",
            "fax_number": "951-769-8998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11188 RUNYAN RD",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922236209",
            "telephone_number": "909-809-9523",
            "fax_number": "951-769-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "GABRIELA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-06",
        "last_updated": "2011-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "59959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, CA

Sources for this page

Verify at the official NPI Registry.