Individual provider Active NPI

Maira Hinojosa, DDS

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1780204990
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
106869 Issued in CA
Practice address
10833 Le Conte Ave
Los Angeles, CA 90095-3075
Phone
(310) 825-6510
NPI assigned
Apr 17, 2020
Last updated
Oct 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 106869 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

10833 Le Conte Ave
Los Angeles, CA 90095-3075

Mailing address

3379 Winthrop St
Concord, CA 94519-2036

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220922003071 CA Order and Referring Only - DentistPractitioner - Dentist 9234514522

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
106869CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1587081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1780204990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3379 WINTHROP ST",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945192036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953075",
            "telephone_number": "310-825-6510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINOJOSA",
        "first_name": "MAIRA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-17",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "106869",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.