Active NPI
Anna Raymond
- Dentist
- Hermosa Beach, CA
National Provider Identifier
1700319316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 103188
- Practice address
- 1559 Pacific Coast Hwy Ste 101
Hermosa Beach, CA 90254 - Phone
- (310) 372-7686
- NPI assigned
- Apr 10, 2017
- Sex
- Female
- Sole proprietor
- No
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 | 103188 | CA | Primary |
Addresses
Primary practice location
1559 Pacific Coast Hwy Ste 101
Hermosa Beach, CA 90254
Mailing address
4500 Via Marina Apt 217
Marina del Rey, CA 90292-7219
Phone (318) 381-3060
Other practice location 1
1559 Pacific Coast Hwy Ste 101
Hermosa Beach, CA 90254
Phone (310) 372-7686
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 |
|---|---|---|---|
| 103188 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oates and Jefferson Dental Corporation | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Hermosa Beach, CA
- NPI 1174961536
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538956800000",
"number": "1700319316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4500 VIA MARINA APT 217",
"city": "MARINA DEL REY",
"state": "CA",
"postal_code": "902927219",
"telephone_number": "318-381-3060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1559 PACIFIC COAST HWY STE 101",
"city": "HERMOSA BEACH",
"state": "CA",
"postal_code": "90254",
"telephone_number": "310-372-7686"
}
],
"practiceLocations": [
{
"address_1": "1559 Pacific Coast Hwy Ste 101",
"address_purpose": "LOCATION",
"city": "Hermosa Beach",
"state": "CA",
"postal_code": "90254",
"country_code": "US",
"telephone_number": "310-372-7686",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RAYMOND",
"first_name": "ANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-10",
"last_updated": "2018-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "103188",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hermosa Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.