Individual provider Active NPI

Scarlett Anai Mineo Escareno, DDS

  • Dentist
  • Pico Rivera, CA
National Provider Identifier
1508589847
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
108069 Issued in CA
Practice address
8812 Whittier Blvd
Pico Rivera, CA 90660-2658
Phone
(562) 394-1322
NPI assigned
Sep 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 108069 CA Primary

Addresses

Primary practice location

8812 Whittier Blvd
Pico Rivera, CA 90660-2658

Mailing address

3025 1/2 Van Buren PL
Los Angeles, CA 90007-3059
Phone (760) 333-4047

Other names 1

  • Scarlett Anai Escareno Mazuca Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230119001023 CA Order and Referring Only - DentistPractitioner - Dentist 5395116958

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Camacho and Zaklama Dental Corporation CurrentSince Sep 25, 2022 Accepting new patients

Locations

8812 Whittier Blvd
Pico Rivera, CA 90660
Phone (562) 394-1322

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.

NPI Registry JSON

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1508589847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3025 1/2 VAN BUREN PL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900073059",
            "telephone_number": "760-333-4047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8812 WHITTIER BLVD",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906602658",
            "telephone_number": "562-394-1322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINEO ESCARENO",
        "first_name": "SCARLETT",
        "middle_name": "ANAI",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "108069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SCARLETT",
            "last_name": "ESCARENO MAZUCA",
            "middle_name": "ANAI",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pico Rivera, CA

Sources for this page

Verify at the official NPI Registry.