Individual provider Active NPI

Melissa Luis Laureola, D.D.S.

  • General Practice Dentistry
  • Hawthorne, CA
National Provider Identifier
1780817577
Registry record updated Feb 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
58477 Issued in CA
Practice address
13450 Hawthorne Blvd
Hawthorne, CA 90250-5806
Phone
(310) 377-6453
NPI assigned
Aug 27, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2011

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 58477 CA Primary

Addresses

Primary practice location

13450 Hawthorne Blvd
Hawthorne, CA 90250-5806

Mailing address

3210 W Avenue 32
Los Angeles, CA 90065-2319
Phone (323) 459-6018

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
58477CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296777600000",
    "number": "1780817577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 W AVENUE 32",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900652319",
            "telephone_number": "323-459-6018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13450 HAWTHORNE BLVD",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902505806",
            "telephone_number": "310-377-6453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUREOLA",
        "first_name": "MELISSA",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-27",
        "last_updated": "2011-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "58477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2011; 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.