Andrea Tatiana Ustarez, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS101788 Issued in CA

Practice address

3945 Whittier Blvd
Los Angeles, CA 90023-2440

Phone

(323) 307-0449

NPI assigned

Mar 28, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544400000000",
    "number": "1881056992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3945 WHITTIER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900232440",
            "telephone_number": "323-307-0449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3945 WHITTIER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900232440",
            "telephone_number": "323-307-0449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "USTAREZ",
        "first_name": "ANDREA",
        "middle_name": "TATIANA",
        "name_prefix": "Ms.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-28",
        "last_updated": "2018-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS101788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Okon Usoro, MD
• Usrc Baldwin Hills LLC
• Usrc Little Tokyo, LLC
• Allison Ussery
• Sara Veronica Ustabas
• Ustawi
• Usteleradiology Los Angeles
• Emily Utagawa, DDS
• Prach Uthayo, MD
• Uti-Ehrlich Medical Group

• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.