NPIMap

Organization Active NPI

Jerry L Lanier DDS, Inc

Doing business as Kids Dental Kare

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1568702389
Registry record updated Feb 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
40088 Issued in CA
Legal business name
JERRY L LANIER DDS, INC
Doing business as
Kids Dental Kare
Practice address
3015 Crenshaw Blvd Ste B
Los Angeles, CA 90016-4264
Phone
(323) 461-9942
NPI assigned
Feb 15, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2013

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

Authorized official

Name
Jerry L Lanier, DDS
Title
Ceo/President
Phone
(323) 461-9942

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 40088 CA Primary

Addresses

Primary practice location

3015 Crenshaw Blvd Ste B
Los Angeles, CA 90016-4264

Mailing address

4905 Hollywood Blvd
Los Angeles, CA 90027-6101
Phone (323) 461-3342

Other identifiers 1

IdentifierTypeStateIssuer
1356489660MedicaidCA

Other names 1

  • Kids Dental Kare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Jerry L Lanier DDS Inc22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1360886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360886400000",
    "number": "1568702389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4905 HOLLYWOOD BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276101",
            "telephone_number": "323-461-3342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 CRENSHAW BLVD STE B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900164264",
            "telephone_number": "323-461-9942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY L LANIER DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-15",
        "last_updated": "2013-02-15",
        "status": "A",
        "authorized_official_last_name": "LANIER",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "323-461-9942",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "40088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356489660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kids Dental Kare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 15, 2013; 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.