Maxima J Ernacio, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

44167 Issued in CA

Practice address

2105 Beverly Blvd
Suite 123
Los Angeles, CA 90057-2216

Phone

(213) 483-8756

Fax

(213) 483-8755

NPI assigned

Aug 8, 2006

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

Other identifiers 1

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.

• Maxima Ernacio , DMD, Inc.

  • General Practice Dentistry
  • Los Angeles, CA
  • NPI 1801075676
  NPD (past) Authorized official

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215993600000",
    "number": "1740290543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 BEVERLY BLVD",
            "address_2": "SUITE 123",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572216",
            "telephone_number": "213-483-8756",
            "fax_number": "213-483-8755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 BEVERLY BLVD",
            "address_2": "SUITE 123",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572216",
            "telephone_number": "213-483-8756",
            "fax_number": "213-483-8755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERNACIO",
        "first_name": "MAXIMA",
        "middle_name": "J",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2008-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "44167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B44167-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erlinda Velasco M.D.Inc.
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• Ernest Shmidt, MD Inc.
• Ernesto B. Banaag, M.D., Inc.
• Ernesto L. Fontecha, MD, Inc
• Ersno Eromo, M.D.
• Amarachi Erondu, MD, MS

• 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 14, 2008; 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.