Individual provider Active NPI

Stela Ninkova Dimitrova-Munro I, DDS

  • Dentist
  • Santa Monica, CA
National Provider Identifier
1811175318
Registry record updated Feb 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
56296 Issued in CA
Practice address
3435 Ocean Park Bulv.
Suite205
Santa Monica, CA 90405
Phone
(877) 375-4559
NPI assigned
Feb 6, 2008
Last updated
Feb 6, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 56296 CA Primary

Addresses

Primary practice location

3435 Ocean Park Bulv.
Suite205
Santa Monica, CA 90405

Mailing address

2817 E Yucca St
Phoenix, AZ 85028-2628
Phone (602) 996-8066

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
56296CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202256000000",
    "number": "1811175318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 E YUCCA ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850282628",
            "telephone_number": "602-996-8066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 OCEAN PARK BULV.",
            "address_2": "SUITE205",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90405",
            "telephone_number": "877-375-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMITROVA-MUNRO",
        "first_name": "STELA",
        "middle_name": "NINKOVA",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-06",
        "last_updated": "2008-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "56296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2008; 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.