NPIMap

Organization Active NPI

Moncada Dental Corporation

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1821130477
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
43643 Issued in CA
Legal business name
MONCADA DENTAL CORPORATION
Practice address
1321 N Vermont Ave Suite B
Los Angeles, CA 90027
Phone
(323) 663-7897
Fax
(323) 663-7803
NPI assigned
Feb 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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

Authorized official

Name
Marcelo G MoncadaNPI 1215935564
Title
Dentist
Phone
(323) 663-7897

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 43643 CA Primary

Addresses

Primary practice location

1321 N Vermont Ave Suite B
Los Angeles, CA 90027

Mailing address

1321 N Vermont Ave Suite B
Los Angeles, CA 90027
Phone (323) 663-7897

National Provider Directory

National Provider Directory

Locations

1321 N Vermont Ave
Ste B
Los Angeles, CA 90027
Phone (323) 663-7897

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184025600000",
    "number": "1821130477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 N VERMONT AVE SUITE B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90027",
            "telephone_number": "323-663-7897",
            "fax_number": "323-663-7803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 N VERMONT AVE SUITE B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90027",
            "telephone_number": "323-663-7897",
            "fax_number": "323-663-7803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONCADA DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-10",
        "status": "A",
        "authorized_official_last_name": "MONCADA",
        "authorized_official_first_name": "MARCELO",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "323-663-7897"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "43643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.