Individual provider Active NPI

Maria Elizabeth Ignacio Hernandez

  • Dental Assistant
  • Los Angeles, CA
National Provider Identifier
1467096479
Registry record updated Nov 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AssistantTaxonomy code 126800000X
License
RDA90778 Issued in CA
Practice address
2604 S Vermont Ave Ste F
Los Angeles, CA 90007-2298
Phone
(323) 212-5495
NPI assigned
Nov 1, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Assistant 126800000X RDA90778 CA Primary

Addresses

Primary practice location

2604 S Vermont Ave Ste F
Los Angeles, CA 90007-2298

Mailing address

2100 Fair Park Ave Apt 115
Los Angeles, CA 90041-1946
Phone (626) 626-0653

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RDA90778CAMDDental Assistant

NPI Registry JSON

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

{
    "created_epoch": "1572566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1467096479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 FAIR PARK AVE APT 115",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900411946",
            "telephone_number": "626-626-0653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 S VERMONT AVE STE F",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900072298",
            "telephone_number": "323-212-5495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "MARIA ELIZABETH",
        "middle_name": "IGNACIO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-01",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "CA",
            "license": "RDA90778",
            "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 Nov 1, 2019; 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.