Active NPI
Rasool Patel II, DDS
- Dentist
- Los Angeles, CA
National Provider Identifier
1508072497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 33374
- Practice address
- 12504 W Washington Blvd
Los Angeles, CA 90066-5506 - Phone
- (310) 390-6272
- Fax
- (310) 390-6674
- NPI assigned
- May 15, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 33374 | CA | Primary |
Addresses
Primary practice location
12504 W Washington Blvd
Los Angeles, CA 90066-5506
Mailing address
2040 255TH St
Lomita, CA 90717-2614
Phone (310) 367-7231
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33374 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John Pedersen D D S Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Los Angeles, CA
- NPI 1811180995
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217376000000",
"number": "1508072497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2040 255TH ST",
"city": "LOMITA",
"state": "CA",
"postal_code": "907172614",
"telephone_number": "310-367-7231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12504 W WASHINGTON BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900665506",
"telephone_number": "310-390-6272",
"fax_number": "310-390-6674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "RASOOL",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-15",
"last_updated": "2008-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "33374",
"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 Jul 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.