Individual provider Active NPI

Stephanie Jara, RDH

  • Dental Hygienist
  • Beverly Hills, CA
National Provider Identifier
1588475172
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
30486 Issued in CA
Practice address
8920 Wilshire Blvd Ste 701
Beverly Hills, CA 90211-2006
Phone
(310) 652-8383
NPI assigned
Jan 14, 2025
Last updated
Jan 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 30486 CA Primary

Addresses

Primary practice location

8920 Wilshire Blvd Ste 701
Beverly Hills, CA 90211-2006

Mailing address

19811 Gresham St
Northridge, CA 91324-3318
Phone (323) 919-6558

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
30486CAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Sleep Health and Wellness PastSince Jan 19, 2025 Accepting new patients
DRS Kevin Michele and Shawn Frawley Beverly Hills Dental Group Inc PastSince Jan 19, 2025 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1736812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1588475172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19811 GRESHAM ST",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913243318",
            "telephone_number": "323-919-6558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8920 WILSHIRE BLVD STE 701",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112006",
            "telephone_number": "310-652-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARA",
        "first_name": "STEPHANIE",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-14",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "30486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; 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.