Dyana Eidelstein, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DDS103849 Issued in CA

Practice address

2825 Santa Monica Blvd Ste 310
Santa Monica, CA 90404-2429

Phone

(310) 828-0700

NPI assigned

Jul 3, 2019

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

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IFGCCD

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.

• San Diego American Indian Health Center

  • Addiction (Substance Use Disorder) Counselor
  • San Diego, CA
  • NPI 1003902917

  Dentist

  Medicare reassignment NPD
• Globodental

  • Dentist
  • Santa Monica, CA
  • NPI 1457764193
  NPD (past)

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

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562112000000",
    "number": "1700448362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30702 HILLTOP WAY",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926752046",
            "telephone_number": "949-813-6296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 SANTA MONICA BLVD STE 310",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042429",
            "telephone_number": "310-828-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIDELSTEIN",
        "first_name": "DYANA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-03",
        "last_updated": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS103849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Egan, DPT
• Jeffrey Michael Egler, M.D.
• Traci Akiko Eguchi, N.P.
• Kevin M Ehrhart, M.D.
• Amanda Ehrman, AMFT
• Richard Neil Eidinger, MD
• Thomas M. Einstein, M.D.
• Amalia Arasula Eisenberg, A.R.N.P.
• Tali Ekstein, M.S., CGC
• Nasser Samir El-Okdi, M.D.

• Dentist in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; 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.