Aida Lizeth Willis, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

27831 Issued in CA

Practice address

732 Mott St Ste 110
San Fernando, CA 91340-4240

Phone

(818) 963-5690

NPI assigned

Jul 29, 2021

Last updated

Jul 30, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• San Fernando Community Hospital

  dba San Fernando Community Health Center

  • Primary Care Clinic/Center
  • San Fernando, CA
  • NPI 1245669555
  NPD (past)

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1629741137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 MOTT ST STE 110",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913404240",
            "telephone_number": "818-963-5690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 MOTT ST STE 110",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913404240",
            "telephone_number": "818-963-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "AIDA",
        "middle_name": "LIZETH",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "27831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Morales Whang, F.N.P
• Katrina White
• Ira Stephen Wiedman, DDS
• Eric Andrew Williams, FNP
• Maria G Williams
• Debbie LR Wolpert, PT
• Brittany Morgan Yahalom
• Michael Guy Yamane, D.D.S.
• Rebecca Sue Yamane
• Yamposlky, Gershfeld Dental Corporation (Ultra Dental Group)

• Dental Hygienist in San Fernando, CA
• Providers in San Fernando, CA by specialty
• Dental Hygienist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; 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.