Individual provider Active NPI

Robert Henry Branch, D.D.S.

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1649377300
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
21547 Issued in CA
Practice address
10300 Compton Ave
Los Angeles, CA 90002-3628
Phone
(323) 357-6602
Fax
(323) 771-7722
NPI assigned
Sep 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 21547 CA Primary

Addresses

Primary practice location

10300 Compton Ave
Los Angeles, CA 90002-3628

Mailing address

5655 Amethyst St
Alta Loma, CA 91737-2104
Phone (909) 980-7201

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
21547CAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649377300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5655 AMETHYST ST",
            "city": "ALTA LOMA",
            "state": "CA",
            "postal_code": "917372104",
            "telephone_number": "909-980-7201",
            "fax_number": "909-980-0271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 COMPTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900023628",
            "telephone_number": "323-357-6602",
            "fax_number": "323-771-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANCH",
        "first_name": "ROBERT",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "21547",
            "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 Jul 8, 2007; 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.