Active NPI
Magnolia Becker, DDS
- Pediatric Dentistry
- Santa Monica, CA
National Provider Identifier
1730467903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 59981
- Practice address
- 1440 23Rd St Apt 210
Santa Monica, CA 90404-2948 - Phone
- (310) 453-7567
- NPI assigned
- Jul 22, 2011
- Last updated
- Jul 22, 2011
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 59981 | CA | Primary |
Addresses
Primary practice location
1440 23Rd St Apt 210
Santa Monica, CA 90404-2948
Mailing address
1440 23Rd St Apt 210
Santa Monica, CA 90404-2948
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151222001672 | CA | Order and Referring Only - Oral Surgery | 2668773326 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59981 | CA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311292800000",
"number": "1730467903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1440 23RD ST APT 210",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904042948"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1440 23RD ST APT 210",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904042948",
"telephone_number": "310-453-7567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECKER",
"first_name": "MAGNOLIA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-22",
"last_updated": "2011-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "59981",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2011; 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.