Individual provider Active NPI

Christian M Blanco, DMD

  • General Practice Dentistry
  • Torrance, CA
National Provider Identifier
1861646903
Registry record updated Nov 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
57871 Issued in CA
Practice address
21805 Anza Ave
Torrance, CA 90503-6901
Phone
(310) 920-9167
NPI assigned
Nov 14, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2008

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 57871 CA Primary

Addresses

Primary practice location

21805 Anza Ave
Torrance, CA 90503-6901

Mailing address

21805 Anza Ave
Torrance, CA 90503-6901
Phone (310) 920-9167

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
57871CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1226620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226620800000",
    "number": "1861646903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21805 ANZA AVE",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905036901",
            "telephone_number": "310-920-9167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21805 ANZA AVE",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905036901",
            "telephone_number": "310-920-9167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCO",
        "first_name": "CHRISTIAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-14",
        "last_updated": "2008-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "57871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.