Enrique Tamayo, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

52474 Issued in CA

Practice address

4400 S Broadway Ste 103
Los Angeles, CA 90037-2792

Phone

(323) 233-9400

Fax

(323) 233-9977

NPI assigned

Jan 29, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tamayo Inc & Lascoe Inc Dental Partnership

  • Dentist
  • Los Angeles, CA
  • NPI 1134637150
  NPD (past) Authorized official
• Georgette Zouein Dental Corp

  • General Practice Dentistry
  • Los Angeles, CA
  • NPI 1598166464
  NPD (past)
• Scott Jacks, DDS, Inc

  • Dentist
  • Santa Ana, CA
  • NPI 1871632745
  NPD (past)
• Western Dental Service, Inc

  • Dentist
  • Santa Ana, CA
  • NPI 1225554793
  NPD (past)

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1811033699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 S BROADWAY STE 103",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900372792",
            "telephone_number": "323-233-9400",
            "fax_number": "323-233-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 S BROADWAY STE 103",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900372792",
            "telephone_number": "323-233-9400",
            "fax_number": "323-233-9977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2144 S Bristol St",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927045123",
            "country_code": "US",
            "telephone_number": "714-619-6280",
            "fax_number": "323-249-7565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAMAYO",
        "first_name": "ENRIQUE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "52474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D52474",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tamayo Inc & Lascoe Inc Dental Partnership
• Alexander Tamayo
• Beatriz Tamayo, MD
• Christian Tamayo, PTA
• Daniel Tamayo
• Jose Samuel Tamayo
• Juan Tamayo
• Michelle Lynn Tamayo
• Patricia Katherina San Pedro Tamayo, DNP
• Rona Lee Tamayo, DDS

• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.