Individual provider Active NPI

Lindsay Anne Costantino, DDS

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1639426604
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
60141 Issued in CA
Practice address
10505 W Pico Blvd
Los Angeles, CA 90064-2319
Phone
(310) 475-0617
NPI assigned
Aug 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 60141 CA Primary

Addresses

Primary practice location

10505 W Pico Blvd
Los Angeles, CA 90064-2319

Mailing address

10505 W Pico Blvd
Los Angeles, CA 90064-2319
Phone (310) 475-0617

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
60141CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dillon Costantino Dental Partnership General Practice CurrentSince Mar 26, 2023 Accepting new patients
Lindsay Costantino, DDS Inc General Practice CurrentSince Feb 2, 2025 Accepting new patients

Locations

10505 W Pico Blvd
Los Angeles, CA 90064
Phone (310) 475-0617

Organizations & group practices 2

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": "1344470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1639426604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10505 W PICO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900642319",
            "telephone_number": "310-475-0617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10505 W PICO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900642319",
            "telephone_number": "310-475-0617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTANTINO",
        "first_name": "LINDSAY",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-09",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "60141",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 24, 2023; 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.