NPIMap

Organization Active NPI

Carmona Dental Inc.

  • General Practice Dentistry
  • South Gate, CA
National Provider Identifier
1548545866
Registry record updated Nov 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
60024 Issued in CA
Legal business name
CARMONA DENTAL INC.
Practice address
4096 Tweedy Blvd
South Gate, CA 90280-6147
Phone
(323) 569-3333
Fax
(323) 569-3334
NPI assigned
Oct 18, 2011
Last updated
Nov 25, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2020

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

Authorized official

Name
Enriqueta Carmona, D.D.S.NPI 1578866430
Title
President
Phone
(323) 569-3333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
General Practice Dentistry 1223G0001X 60024 CA Primary

Addresses

Primary practice location

4096 Tweedy Blvd
South Gate, CA 90280-6147

Mailing address

4096 Tweedy Blvd
South Gate, CA 90280-6147
Phone (323) 569-3333

National Provider Directory

National Provider Directory

Locations

4096 Tweedy Blvd
South Gate, CA 90280
Phone (323) 569-3333

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1318896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606262400000",
    "number": "1548545866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4096 TWEEDY BLVD",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902806147",
            "telephone_number": "323-569-3333",
            "fax_number": "323-569-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4096 TWEEDY BLVD",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902806147",
            "telephone_number": "323-569-3333",
            "fax_number": "323-569-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARMONA DENTAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-18",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A",
        "authorized_official_last_name": "CARMONA",
        "authorized_official_first_name": "ENRIQUETA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-569-3333",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "60024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Gate, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; 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.