Individual provider Active NPI

Rosemarie Acevedo, D.D.S

  • General Practice Dentistry
  • North Hollywood, CA
National Provider Identifier
1811399306
Registry record updated Sep 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
43507 Issued in CA
Practice address
11559 Sherman Way Unit 100
North Hollywood, CA 91605-5883
Phone
(818) 503-0040
Fax
(818) 503-0090
NPI assigned
Sep 16, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2014

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 43507 CA Primary

Addresses

Primary practice location

11559 Sherman Way Unit 100
North Hollywood, CA 91605-5883

Mailing address

6725 De Celis PL
Lake Balboa, CA 91406-5713
Phone (818) 781-6030

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
43507CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rosemarie Acevedo-Walker D.D.S 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410825600000",
    "number": "1811399306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6725 DE CELIS PL",
            "city": "LAKE BALBOA",
            "state": "CA",
            "postal_code": "914065713",
            "telephone_number": "818-781-6030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11559 SHERMAN WAY UNIT 100",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916055883",
            "telephone_number": "818-503-0040",
            "fax_number": "818-503-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACEVEDO",
        "first_name": "ROSEMARIE",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-16",
        "last_updated": "2014-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Hollywood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; 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.