Alivia Jane Stoddard, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

106821 Issued in CA

Practice address

14101 Nelson Ave
La Puente, CA 91746-2640

Phone

(425) 318-2081

NPI assigned

Aug 31, 2021

Sex

Female

Sole proprietor

No

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1629746045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12132 CONCORD CT",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102161",
            "telephone_number": "425-318-2081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14101 NELSON AVE",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917462640",
            "telephone_number": "425-318-2081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STODDARD",
        "first_name": "ALIVIA",
        "middle_name": "JANE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "106821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern California Health Cares (Life Sharing)
• Southern California Infectious Disease Physicians Medical Group Inc
• Rachel Victoria Sportelli
• Sreedhar Chava MD Inc
• St. Mary Joseph Homes Inc
• Alexa Stubblefield, PSS
• David Sun
• Chung Han Sung, L.AC.
• Sunkist Multispecialty Medical Clinic, Inc
• Susanto Dental Corporation

• General Practice Dentistry in La Puente, CA
• Providers in La Puente, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.