NPIMap

Organization Active NPI

Utibe Effiom DDS, Inc.

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1861938474
Registry record updated Jan 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
54249 Issued in CA
Legal business name
UTIBE EFFIOM DDS, INC.
Practice address
3991 S Western Ave
#7
Los Angeles, CA 90062-1193
Phone
(310) 397-1064
NPI assigned
Jan 6, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2017

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

Authorized official

Name
Dr. Utibe Effiom, DDSNPI 1013109867
Title
President
Phone
(310) 397-1064

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 54249 CA Primary

Addresses

Primary practice location

3991 S Western Ave
#7
Los Angeles, CA 90062-1193

Mailing address

PO Box 341935
Los Angeles, CA 90034-8983
Phone (310) 397-1064

Other names 1

  • Leimert Dental Practice of Utibe Effiom DDS, Inc. Doing business as

National Provider Directory

National Provider Directory

Locations

3991 S Western Ave
Ste 7
Los Angeles, CA 90062
Phone (310) 397-1064

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": "1483660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483660800000",
    "number": "1861938474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 341935",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900348983",
            "telephone_number": "310-397-1064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3991 S WESTERN AVE",
            "address_2": "#7",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900621193",
            "telephone_number": "310-397-1064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTIBE EFFIOM DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-06",
        "last_updated": "2017-01-06",
        "status": "A",
        "authorized_official_last_name": "EFFIOM",
        "authorized_official_first_name": "UTIBE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-397-1064",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Leimert Dental Practice of Utibe Effiom DDS, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 6, 2017; 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.