Courtney Ray Mittelmark, D.M.D., M.S.D., a Professional Corp.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

61908 Issued in CA

Legal business name

COURTNEY RAY MITTELMARK, D.M.D., M.S.D., A PROFESSIONAL CORP.

Doing business as

Playa Vista Orthodontics

Practice address

8540 S Sepulveda Blvd
#700
Los Angeles, CA 90045-3807

Phone

(310) 216-0101

Fax

(310) 216-1279

NPI assigned

Dec 22, 2008

Last updated

Jan 25, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Fabiola Ortega-Frasch

Title

Manager

Phone

(310) 216-0101

Specialties & licenses 1

Addresses

Other names 1

• Playa Vista Orthodontics Doing business as

Locations

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.

• Michael Louis Luther, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Los Angeles, CA
  • NPI 1275633570
  NPD (past)

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

{
    "created_epoch": "1229904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453680000000",
    "number": "1588800510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8540 S SEPULVEDA BLVD",
            "address_2": "#700",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453807",
            "telephone_number": "310-216-0101",
            "fax_number": "310-216-1279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8540 S SEPULVEDA BLVD",
            "address_2": "#700",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453807",
            "telephone_number": "310-216-0101",
            "fax_number": "310-216-1279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COURTNEY RAY MITTELMARK, D.M.D., M.S.D., A PROFESSIONAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-22",
        "last_updated": "2016-01-25",
        "status": "A",
        "authorized_official_last_name": "ORTEGA-FRASCH",
        "authorized_official_first_name": "FABIOLA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "310-216-0101"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "61908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Playa Vista Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Greta M Couper
• Courageous Change Marriage and Family Therapy, Apc
• Emily Coursen, M.S., CCC-SLP
• Kate Marie Coursey
• Courtnay Meletta
• Grant Edward Courtney, LCSW
• Kirsten Michelle Courtney, DC
• Nicole Goren Courtney, LMFT120155
• Marina Eugenie Coury
• Shanice Cousin

• Dental Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; 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.