Omar J Fernandez, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

53449 Issued in CA

Practice address

811 S Alvarado St
Los Angeles, CA 90057-4009

Phone

(213) 383-3314

Fax

(213) 383-0621

NPI assigned

Feb 8, 2007

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Alireza Movassaghi DDS Inc

  • Dentist
  • Los Angeles, CA
  • NPI 1497966212
  NPD (past)

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700927340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10720 LA REINA AVE",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902413419",
            "telephone_number": "626-216-2258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 S ALVARADO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900574009",
            "telephone_number": "213-383-3314",
            "fax_number": "213-383-0621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "OMAR",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marisol Fernandez, SFIDC
• Mark Fernandez
• Miguel Angel Fernandez
• Miranda Fernandez
• Nancy Fernandez
• Rachel Renee Fernandez
• Ramon Fernandez
• Randy Fernandez
• Raymond Fernandez, MFTI
• Sacha Fernandez, LCSW

• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.