Dr. Fernando de la Pena Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

43934 Issued in CA

Legal business name

DR. FERNANDO DE LA PENA DENTAL CORPORATION

Practice address

2701 Beverly Blvd
Los Angeles, CA 90057-1007

Phone

(213) 389-6211

NPI assigned

Mar 5, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Fernando De la Pena, D.M.D.NPI 1174652135

Title

President

Phone

(213) 389-6211

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• De La Pena Dental Group Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Fernando De la Pena, D.M.D.

  • General Practice Dentistry
  • Los Angeles, CA
  • NPI 1174652135
  NPD (past) Authorized official

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221004800000",
    "number": "1740319094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 BEVERLY BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900571007",
            "telephone_number": "213-389-6211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 BEVERLY BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900571007",
            "telephone_number": "213-389-6211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. FERNANDO DE LA PENA DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2008-09-10",
        "status": "A",
        "authorized_official_last_name": "DE LA PENA",
        "authorized_official_first_name": "FERNANDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-389-6211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL PROVIDER NO.",
            "identifier": "B43934-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "De La Pena Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dr. Ehteram Benji Behroozan
• Dr. Ellen Goldstein Inc.
• Dr. Elliott Caine Optometry, Inc
• Dr. Elliott Moscot Optometric Corporation
• Dr. Eric Chaghouri M.D., a Professional Medical Corporation
• Dr. Fred Chao, DDS, Inc
• Dr. G.S. Frankel Dental Group
• Dr. Gording,Optometry, P.C.
• Dr. Hansung Bryan Kim DDS, Inc.
• Dr. Hansung Bryan Kim, DDS Inc.

• 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 Sep 10, 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.