Individual provider Active NPI

Ramon Zabala Nacilla, D.M.D.

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1780748517
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
27907 Issued in CA
Practice address
4985 Eagle Rock Blvd
Los Angeles, CA 90041-1921
Phone
(323) 254-1212
Fax
(323) 254-1183
NPI assigned
Dec 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 27907 CA Primary

Addresses

Primary practice location

4985 Eagle Rock Blvd
Los Angeles, CA 90041-1921

Mailing address

4985 Eagle Rock Blvd
Los Angeles, CA 90041-1921
Phone (323) 254-1212

Other identifiers 1

IdentifierTypeStateIssuer
27907-01OtherCADENTI-CAL

Other names 1

  • Dr. Ramon Zabala Nacilla Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
27907CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780748517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4985 EAGLE ROCK BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900411921",
            "telephone_number": "323-254-1212",
            "fax_number": "323-254-1183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4985 EAGLE ROCK BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900411921",
            "telephone_number": "323-254-1212",
            "fax_number": "323-254-1183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NACILLA",
        "first_name": "RAMON",
        "middle_name": "ZABALA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "27907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "27907-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAMON",
            "last_name": "NACILLA",
            "middle_name": "ZABALA",
            "prefix": "DR.",
            "credential": "D.M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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 Jul 8, 2007; 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.