Active NPI
Jeanae Arevalo
- Dental Assistant
- Los Angeles, CA
National Provider Identifier
1669863023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- 83365
- Practice address
- 380 S Ferris Ave
Los Angeles, CA 90022-1921 - Phone
- (818) 523-4320
- NPI assigned
- Feb 6, 2015
- 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 |
|---|---|---|---|---|
| Dental Assistant | 126800000X | 83365 | CA | Primary |
Addresses
Primary practice location
380 S Ferris Ave
Los Angeles, CA 90022-1921
Mailing address
2604 S Vermont Ave
Los Angeles, CA 90007-2298
Phone (323) 731-3333
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 |
|---|---|---|---|
| 83365 | CA | MD | Dental Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423180800000",
"number": "1669863023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2604 S VERMONT AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900072298",
"telephone_number": "323-731-3333",
"fax_number": "323-731-7626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "380 S FERRIS AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900221921",
"telephone_number": "818-523-4320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AREVALO",
"first_name": "JEANAE",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-02-06",
"last_updated": "2015-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "CA",
"license": "83365",
"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 Feb 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.