Annie Ledoux, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

61188 Issued in CA

Practice address

4816 E 3Rd St
Los Angeles, CA 90022-1602

Phone

(323) 780-4510

NPI assigned

May 3, 2012

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

Locations

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.

• Gracelight Community Health

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1104075282
  Medicare reassignment NPD

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

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1689933178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 S GRAND AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900154202",
            "telephone_number": "323-669-4346",
            "fax_number": "323-635-1891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4816 E 3RD ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221602",
            "telephone_number": "323-780-4510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4618 Fountain Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900291977",
            "country_code": "US",
            "telephone_number": "323-953-7170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEDOUX",
        "first_name": "ANNIE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-03",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "61188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Ledezma, LVN
• Mateo L. Ledezma, MD
• Perla Ledezma
• Clarissa Joyce Ledford, MSN, NNP B-C
• Iskra Isabel Ledic, FNP-C, MSN, PHN
• Paola Ledwin
• Lee & Bae Gi Medical Corporation
• Emma Kealani Lynn Lee Archambeau
• Alfredo Lee Chang, MD
• Lee Chiropractic & Angel Health Center, Inc.

• Dentist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; 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.