Adrienne Gallegos Carillo, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

110781 Issued in CA

Practice address

721 W Huntington Dr Ste B
Arcadia, CA 91007-6734

Phone

(626) 574-1766

NPI assigned

Nov 14, 2024

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

Practice roles

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.

• Hambik Oktanyan Dental Corporation

  dba Santa Anita Dental Group

  • General Practice Dentistry
  • Arcadia, CA
  • NPI 1588799126
  NPD (past)

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

{
    "created_epoch": "1731542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1689498834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17138 GUMBINER DR",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917443311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 W HUNTINGTON DR STE B",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910076734",
            "telephone_number": "626-574-1766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARILLO",
        "first_name": "ADRIENNE",
        "middle_name": "GALLEGOS",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-14",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "110781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Cao, FNP-BC
• Quoc Cao
• Cardiovascular Consultants of San Gabriel Valley, Inc.
• Cardiovascular Network of Southern California
• Care Net Home Health Inc
• Susan Carillo
• Caring Help Hospice Agency, Inc.
• Carl J. Chang, M.D., Inc.
• Robert B. Carleton, PA-C
• Betzaira Carlos

• General Practice Dentistry in Arcadia, CA
• Providers in Arcadia, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.