Centinela Joseph Dental Group

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

CENTINELA JOSEPH DENTAL GROUP

Doing business as

EZ Dental and Orthodontics

Practice address

6907 La Tijera Blvd
Los Angeles, CA 90045-1906

Phone

(310) 645-0336

Fax

(310) 645-9250

NPI assigned

Nov 2, 2020

Last updated

Nov 2, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

TILDEN BAY JOSEPH DENTAL GROUPAs reported in NPPES

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

Authorized official

Name

Joesph Azizi

Title

President/Owner

Phone

(310) 466-9571

Specialties & licenses 1

Addresses

Other names 1

• EZ Dental and Orthodontics Doing business as

Part of

Tilden Bay Joseph Dental Group

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Tilden Bay Joseph Dental Group

  dba Green Dental & Orthodontics

  • General Practice Dentistry
  • Sherman Oaks, CA
  • NPI 1841627825
  NPPES parent name

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

{
    "created_epoch": "1604275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604275200000",
    "number": "1851992481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2934 1/2 BEVERLY GLEN CIRCLE #451",
            "address_2": "451",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900771724",
            "telephone_number": "310-695-1589",
            "fax_number": "818-782-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6907 LA TIJERA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900451906",
            "telephone_number": "310-645-0336",
            "fax_number": "310-645-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTINELA JOSEPH DENTAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TILDEN BAY JOSEPH DENTAL GROUP",
        "enumeration_date": "2020-11-02",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A",
        "authorized_official_last_name": "AZIZI",
        "authorized_official_first_name": "JOESPH",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "310-466-9571"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EZ Dental and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Hugo Centomo, M.D PH.D.
• Central City Community Health Center Inc

• Dentist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.