Active NPI
Jamie Leah Telles, RDA
- Dental Assistant
- Hemet, CA
National Provider Identifier
1699294439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- RDA81056
- Practice address
- 3027 W Florida Ave
Hemet, CA 92545-3617 - Phone
- (951) 791-9111
- NPI assigned
- Sep 13, 2017
- Last updated
- Sep 13, 2017
- 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 | RDA81056 | CA | Primary |
Addresses
Primary practice location
3027 W Florida Ave
Hemet, CA 92545-3617
Mailing address
3027 Florida Ave
Hemet, CA 92545
Phone (951) 791-9111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RDA81056 | Other | CA | DENTAL BOARD OF CALIFORNIA |
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 |
|---|---|---|---|
| RDA81056 | CA | MD | Dental Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505260800000",
"number": "1699294439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3027 FLORIDA AVE",
"city": "HEMET",
"state": "CA",
"postal_code": "92545",
"telephone_number": "951-791-9111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3027 W FLORIDA AVE",
"city": "HEMET",
"state": "CA",
"postal_code": "925453617",
"telephone_number": "951-791-9111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TELLES",
"first_name": "JAMIE",
"middle_name": "LEAH",
"credential": "RDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-09-13",
"last_updated": "2017-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "CA",
"license": "RDA81056",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL BOARD OF CALIFORNIA",
"identifier": "RDA81056",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hemet, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.