Active NPI
Hadil Goubrail, DDS
- Dentist
- Cerritos, CA
National Provider Identifier
1689384943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DDS108327
- Practice address
- 12163 Saint Tropez Dr
Cerritos, CA 90703-2766 - Phone
- (310) 658-6695
- NPI assigned
- Nov 28, 2022
- 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 | DDS108327 | CA | Primary |
Addresses
Primary practice location
12163 Saint Tropez Dr
Cerritos, CA 90703-2766
Mailing address
12163 Saint Tropez Dr
Cerritos, CA 90703-2766
Phone (310) 658-6695
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230427002452 | CA | Order and Referring Only - Dentist | 8628433505 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DDS108327 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669593600000",
"number": "1689384943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12163 SAINT TROPEZ DR",
"city": "CERRITOS",
"state": "CA",
"postal_code": "907032766",
"telephone_number": "310-658-6695"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12163 SAINT TROPEZ DR",
"city": "CERRITOS",
"state": "CA",
"postal_code": "907032766",
"telephone_number": "310-658-6695"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOUBRAIL",
"first_name": "HADIL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-11-28",
"last_updated": "2022-11-28",
"certification_date": "2022-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "DDS108327",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cerritos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; 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.