NPIMap

Organization Active NPI

Gonzalo Echarte Professional Dental Corporation

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1629259080
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
52379 Issued in CA
Legal business name
GONZALO ECHARTE PROFESSIONAL DENTAL CORPORATION
Practice address
525 S Alvarado St
Los Angeles, CA 90057-2903
Phone
(212) 483-1221
NPI assigned
Nov 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2007

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

Authorized official

Name
Gonzalo Echarte, DDS
Title
President
Phone
(213) 483-1221

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 52379 CA Primary

Addresses

Primary practice location

525 S Alvarado St
Los Angeles, CA 90057-2903

Mailing address

525 S Alvarado St
Los Angeles, CA 90057-2903
Phone (212) 483-1221

Other identifiers 1

IdentifierTypeStateIssuer
G93205OtherCAMEDICARE

National Provider Directory

National Provider Directory
Tax ID family
Echarte Fernandez Professional Dental Corporation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

525 S Alvarado St
Los Angeles, CA 90057
Phone (212) 483-1221

NPI Registry JSON

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1629259080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 S ALVARADO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572903",
            "telephone_number": "212-483-1221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 S ALVARADO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572903",
            "telephone_number": "212-483-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GONZALO ECHARTE PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "ECHARTE",
        "authorized_official_first_name": "GONZALO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-483-1221",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "52379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "G93205",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Nov 14, 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.