Active NPI
Phyllis Dianne Lewis, RDHAP
- Dental Hygienist
- Los Angeles, CA
National Provider Identifier
1477839330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- HAP 142
- Practice address
- 5635 S Verdun Ave
Los Angeles, CA 90043-2123 - Phone
- (310) 916-2291
- NPI assigned
- Oct 24, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | HAP 142 | CA | Primary |
Addresses
Primary practice location
5635 S Verdun Ave
Los Angeles, CA 90043-2123
Mailing address
5635 S Verdun Ave
Los Angeles, CA 90043-2123
Phone (310) 916-2291
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
| License | State | Type | Specialty |
|---|---|---|---|
| HAP 142 | CA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319414400000",
"number": "1477839330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5635 S VERDUN AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900432123",
"telephone_number": "310-916-2291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5635 S VERDUN AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900432123",
"telephone_number": "310-916-2291"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "PHYLLIS",
"middle_name": "DIANNE",
"credential": "RDHAP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-24",
"last_updated": "2011-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "HAP 142",
"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 Oct 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.