Eva L Hogan, MUDR DDS MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DS45113 Issued in CA

Practice address

11980 San Vicente Blvd
503
Los Angeles, CA 90049

Phone

(310) 966-9444

Fax

(310) 820-4585

NPI assigned

Oct 6, 2006

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 CA

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649367350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11980 SAN VICENTE BLVD",
            "address_2": "503",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90049",
            "telephone_number": "310-966-9444",
            "fax_number": "310-820-4585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11980 SAN VICENTE BLVD",
            "address_2": "503",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90049",
            "telephone_number": "310-966-9444",
            "fax_number": "310-820-4585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "EVA",
        "middle_name": "L",
        "credential": "MUDR DDS MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "DS45113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gil Dov Hoftman, M.D., PH.D.
• Nir Nahum Hoftman, MD
• Alexis Ann Hogan
• Amber Yaeko Hogan, CCC-SLP
• Crystal A Hogan
• Jennifer Lynn Hogan, CRNA
• Jessica Hogan
• Jessica Lynn Hogan, PSYD, LP
• Lonnie Bernard Hogan
• Rita Ita Hogan

• Periodontics in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.