Individual provider Active NPI

Llely Duarte, DDS

  • General Practice Dentistry
  • Oxnard, CA
National Provider Identifier
1679109987
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
111035 Issued in CA
Practice address
3611 W 5TH St Ste a
Oxnard, CA 93030-6426
Phone
(805) 985-1800
NPI assigned
Mar 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 17174 MD
General Practice Dentistry 1223G0001X 111035 CA Primary

Addresses

Primary practice location

3611 W 5TH St Ste a
Oxnard, CA 93030-6426

Mailing address

3611 W 5TH St Ste a
Oxnard, CA 93030-6426
Phone (805) 985-1800

Other practice location 1

2731 S Rose Ave Ste 101
Oxnard, CA 93033-3964
Phone (805) 483-3658

Other practice location 2

5757 Wilshire Blvd Ste 559
Los Angeles, CA 90036-3683
Phone (323) 934-9588

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
111035CAMDGeneral Practice Dentistry
17174MDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sandy Gabriel, DDS Inc General Practice CurrentSince Mar 30, 2025 Accepting new patients
Dental Dreams, LLC General Practice PastSince Sep 1, 2020 Accepting new patients
Lewis a. Enstedt, D.D.S, Apc Past Accepting new patients
Keith Johnson Dental Corporation General Practice Past Accepting new patients
Mitchell Levitt, DMD, a Professional Dental Corporation Past Accepting new patients
S. Gabriel Dental Corporation PastSince Dec 6, 2022 Accepting new patients
Marina Dental PastSince Mar 30, 2025 Accepting new patients

Locations

3611 W 5th St
Ste A
Oxnard, CA 93030
Phone (805) 985-1800

Organizations & group practices 7

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": "1584489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1679109987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 W 5TH ST STE A",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930306426",
            "telephone_number": "805-985-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 W 5TH ST STE A",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930306426",
            "telephone_number": "805-985-1800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2731 S Rose Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Oxnard",
            "state": "CA",
            "postal_code": "930333964",
            "country_code": "US",
            "telephone_number": "805-483-3658",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5757 Wilshire Blvd Ste 559",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900363683",
            "country_code": "US",
            "telephone_number": "323-934-9588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUARTE",
        "first_name": "LLELY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-18",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "17174",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "111035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; 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.