NPIMap

Organization Active NPI

Fredia Isis Cadavid

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1750978763
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
FREDIA ISIS CADAVID
Practice address
875 N Western Ave
Los Angeles, CA 90029-3759
Phone
(562) 572-8261
NPI assigned
Dec 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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

Authorized official

Name
Dr. Fredia Isis Cadavid
Title
Owner
Phone
(562) 572-8261

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

875 N Western Ave
Los Angeles, CA 90029-3759

Mailing address

875 N Western Ave
Los Angeles, CA 90029-3759
Phone (562) 572-8261

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1608681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609718400000",
    "number": "1750978763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 N WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900293759",
            "telephone_number": "562-572-8261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 N WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900293759",
            "telephone_number": "562-572-8261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDIA ISIS CADAVID",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-23",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A",
        "authorized_official_last_name": "CADAVID",
        "authorized_official_first_name": "FREDIA",
        "authorized_official_middle_name": "ISIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "562-572-8261",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; 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.