Active NPI
Michael Drake
- Dentist
- Santa Monica, CA
National Provider Identifier
1750783601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 63505
- Practice address
- 1243 7TH St Ste a
Santa Monica, CA 90401-1658 - Phone
- (310) 451-5348
- NPI assigned
- Sep 23, 2014
- Last updated
- Apr 3, 2018
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 63505 | CA | Primary |
Addresses
Primary practice location
1243 7TH St Ste a
Santa Monica, CA 90401-1658
Mailing address
1243 7TH St Ste a
Santa Monica, CA 90401-1658
Phone (310) 451-5348
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 |
|---|---|---|---|---|
| I20150914002376 | CA | Order and Referring Only - Dentist | 9830406594 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael N. Drake D.M.D., Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522713600000",
"number": "1750783601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1243 7TH ST STE A",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904011658",
"telephone_number": "310-451-5348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1243 7TH ST STE A",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904011658",
"telephone_number": "310-451-5348"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRAKE",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-09-23",
"last_updated": "2018-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "63505",
"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 Apr 3, 2018; 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.