Individual provider Active NPI

Teresita G Pabalan, DMD

  • Dentist
  • Norwalk, CA
National Provider Identifier
1629176102
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
36408 Issued in CA
Practice address
11818 Rosecrans Ave
Suite B
Norwalk, CA 90650-4101
Phone
(562) 406-3826
Fax
(562) 868-4444
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 36408 CA Primary

Addresses

Primary practice location

11818 Rosecrans Ave
Suite B
Norwalk, CA 90650-4101

Mailing address

11818 Rosecrans Ave
Suite B
Norwalk, CA 90650-4101
Phone (562) 406-3826

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
36408CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Eun Soo Lee DDS Inc PastSince Feb 2, 2020 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629176102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11818 ROSECRANS AVE",
            "address_2": "SUITE B",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906504101",
            "telephone_number": "562-406-3826",
            "fax_number": "562-868-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11818 ROSECRANS AVE",
            "address_2": "SUITE B",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906504101",
            "telephone_number": "562-406-3826",
            "fax_number": "562-868-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PABALAN",
        "first_name": "TERESITA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "36408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.