NPIMap

Organization Active NPI

Reynaldo D Eclavea, DMD, Inc

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1447670617
Registry record updated Apr 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
34952 Issued in CA
Legal business name
REYNALDO D ECLAVEA, DMD, INC
Practice address
3508 W Sunset Blvd # B
Los Angeles, CA 90026-2106
Phone
(323) 660-3876
Fax
(323) 660-0476
NPI assigned
Apr 25, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2014

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

Authorized official

Name
Dr. Reynaldo Dimasin Eclavea, DMDNPI 1679611933
Title
President
Phone
(323) 660-3876

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 34952 CA Primary

Addresses

Primary practice location

3508 W Sunset Blvd # B
Los Angeles, CA 90026-2106

Mailing address

3508 W Sunset Blvd # B
Los Angeles, CA 90026-2106
Phone (323) 660-3876

Other identifiers 1

IdentifierTypeStateIssuer
B34952-01OtherCAMEDICAL

National Provider Directory

National Provider Directory

Locations

3508 W Sunset Blvd
#B
Los Angeles, CA 90026
Phone (323) 660-3876

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": "1398384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398384000000",
    "number": "1447670617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3508 W SUNSET BLVD # B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900262106",
            "telephone_number": "323-660-3876",
            "fax_number": "323-660-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3508 W SUNSET BLVD # B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900262106",
            "telephone_number": "323-660-3876",
            "fax_number": "323-660-0476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REYNALDO D ECLAVEA, DMD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-25",
        "last_updated": "2014-04-25",
        "status": "A",
        "authorized_official_last_name": "ECLAVEA",
        "authorized_official_first_name": "REYNALDO",
        "authorized_official_middle_name": "DIMASIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-660-3876",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "34952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "B34952-01",
            "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 Apr 25, 2014; 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.