Active NPI
Goretti Li
- Dentist
- Monterey Park, CA
National Provider Identifier
1639596166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 40960
- Practice address
- 2176 S Atlantic Blvd
Monterey Park, CA 91754-6839 - Phone
- (323) 888-0681
- NPI assigned
- Mar 21, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 40960 | CA | Primary |
Addresses
Primary practice location
2176 S Atlantic Blvd
Monterey Park, CA 91754-6839
Mailing address
2176 S Atlantic Blvd
Monterey Park, CA 91754-6839
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891889291 | Other | CA | NPI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 40960 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Goretti Li DDS Inc. | Past | Accepting new patients | |
| K. Fan D.D.S., Inc. | Past | Accepting new patients |
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.
-
- General Practice Dentistry
- Monterey Park, CA
- NPI 1891889291
-
- Dental Clinic/Center
- Monterey Park, CA
- NPI 1518424746
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395360000000",
"number": "1639596166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2176 S ATLANTIC BLVD",
"city": "MONTEREY PARK",
"state": "CA",
"postal_code": "917546839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2176 S ATLANTIC BLVD",
"city": "MONTEREY PARK",
"state": "CA",
"postal_code": "917546839",
"telephone_number": "323-888-0681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LI",
"first_name": "GORETTI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-03-21",
"last_updated": "2014-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "40960",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1891889291",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monterey Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.