Active NPI
Dominique Diaz
- Dental Hygienist
- Los Angeles, CA
National Provider Identifier
1831596816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 25511
- Practice address
- 1127 Wilshire Blvd Ste 1504
Los Angeles, CA 90017-4006 - Phone
- (213) 201-1388
- NPI assigned
- Nov 19, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 25511 | CA | Primary |
Addresses
Primary practice location
1127 Wilshire Blvd Ste 1504
Los Angeles, CA 90017-4006
Mailing address
748 1/2 Mountain View Ave
Monrovia, CA 91016
Phone (626) 610-6654
Other names 1
- Dominique Francisco
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416355200000",
"number": "1831596816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "748 1/2 MOUNTAIN VIEW AVE",
"city": "MONROVIA",
"state": "CA",
"postal_code": "91016",
"telephone_number": "626-610-6654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1127 WILSHIRE BLVD STE 1504",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900174006",
"telephone_number": "213-201-1388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "DOMINIQUE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-11-19",
"last_updated": "2014-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "25511",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DOMINIQUE",
"last_name": "FRANCISCO",
"code": "1",
"type": "Former Name"
}
]
}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 Nov 19, 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.