NPIMap

Organization Active NPI

Jerry L Lanier DDS Inc.

Doing business as Kids Dental Kare

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1629148895
Registry record updated Jun 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
40088 Issued in CA
Legal business name
JERRY L LANIER DDS INC.
Doing business as
Kids Dental Kare
Practice address
1155 N Vermont Ave Ste 100
Los Angeles, CA 90029-1759
Phone
(323) 461-9942
Fax
(323) 461-8147
NPI assigned
Nov 8, 2006
Last updated
Jun 24, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2016

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

Authorized official

Name
Dr. Jerry Lee Lanier
Title
President
Phone
32324619942

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 40088 CA Primary

Addresses

Primary practice location

1155 N Vermont Ave Ste 100
Los Angeles, CA 90029-1759

Mailing address

1155 N Vermont Ave Ste 100
Los Angeles, CA 90029-1759
Phone (323) 461-9942

Other identifiers 1

IdentifierTypeStateIssuer
B40088MedicaidCA

Other names 1

  • Kids Dental Kare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Star Tek Adult Dental Group22 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

Locations

1155 N Vermont Ave
Ste 100
Los Angeles, CA 90029
Phone (323) 461-9942

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466726400000",
    "number": "1629148895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 N VERMONT AVE STE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900291759",
            "telephone_number": "323-461-9942",
            "fax_number": "323-461-8147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 N VERMONT AVE STE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900291759",
            "telephone_number": "323-461-9942",
            "fax_number": "323-461-8147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY L LANIER DDS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2016-06-24",
        "status": "A",
        "authorized_official_last_name": "LANIER",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "32324619942",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "40088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B40088",
            "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 Jun 24, 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.