Austin Charles Collazo, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

108679 Issued in CA

Practice address

14248 Hawthorne Blvd
Hawthorne, CA 90250-7008

Phone

(501) 247-4888

NPI assigned

Apr 27, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Western Dental Services, Inc.

  • Dentist
  • Hawthorne, CA
  • NPI 1326194721
  NPD (past)

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1497280358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 N DOHENY DR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902103526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14248 HAWTHORNE BLVD",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902507008",
            "telephone_number": "501-247-4888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1407 W 84th Ave Unit B8",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802604753",
            "country_code": "US",
            "telephone_number": "720-214-4746",
            "fax_number": "720-214-4745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLAZO",
        "first_name": "AUSTIN",
        "middle_name": "CHARLES",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-27",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "108679",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00203202",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497280358",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coastal Communication Center
• Monica Lorene Cody, MA, CADC-II
• Cohen Sedgh, Manavi & Pakravan Dental Corporation
• Azana Coleman
• Hector Eduardo Collantes Jr., PA-C
• Dorin Melida Collins, AMFT
• Chrystal Amalia Colon, RDA
• Complete Dental Care Dental Group, Office of Darien Ephram D.D.S.
• Complete Medical Healthcare Consulting, Inc
• Complete Sleep Inc

• Dentist in Hawthorne, CA
• Providers in Hawthorne, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; 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.