Mia Larissa Ancheta, DDS
Individual provider Active NPI General Practice Dentistry · El Monte, CA
NPI 1740407451 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1740407451
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 47839 (CA)
- Practice address
- 3560 Lexington Ave
El Monte, CA 91731-2608 - Phone
- (626) 448-9867
- Fax
- (626) 448-2202
- NPI assigned
- Apr 20, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160503001411 | CA | Order and Referring Only - Dentist |
0648579219 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mia Larissa Ancheta, DDS, a Dental Corporation | Current | Accepting new patients | |
| Luis Arturo Alvarado DDS Inc | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 47839 | CA | Yes |
Addresses
Primary practice location
3560 Lexington Ave
El Monte, CA 91731-2608
Mailing address
3560 Lexington Ave
El Monte, CA 91731-2608
Phone (626) 448-9867
Other providers in El Monte, CA
- Amjn Pharmacy Inc
- Isabel Amorim
- Elsa Anamuro-Cabrera
- Laura Ivette Anaya Jurado
- Veronica Anaya
- Lacey M Andel
- Victor Andon
- Elijah Andrade
- Andre Widodo DDS a Professional Corporation
- Annie H Nguyen OD Inc
All providers in El Monte, CA · General Practice Dentistry in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.