Individual provider Active NPI

Philip Michael Mottola, DDS

  • General Practice Dentistry
  • Tarzana, CA
National Provider Identifier
1801936430
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19563 Issued in CA
Practice address
18399 Ventura Blvd Ste 234
Tarzana, CA 91356-6409
Phone
(818) 708-3232
Fax
(818) 996-6049
NPI assigned
Feb 6, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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 19563 CA Primary

Addresses

Primary practice location

18399 Ventura Blvd Ste 234
Tarzana, CA 91356-6409

Mailing address

18399 Ventura Blvd Ste 234
Tarzana, CA 91356-6409
Phone (818) 708-3232

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
19563CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Zargarpour Dental Group, 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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801936430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18399 VENTURA BLVD STE 234",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913566409",
            "telephone_number": "818-708-3232",
            "fax_number": "818-996-6049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18399 VENTURA BLVD STE 234",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913566409",
            "telephone_number": "818-708-3232",
            "fax_number": "818-996-6049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTTOLA",
        "first_name": "PHILIP",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "19563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, 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.