Individual provider Active NPI

Iliana Yanet Ortiz, RDA REGISTERED DENTA

  • Dental Assistant
  • Long Beach, CA
National Provider Identifier
1881065290
Registry record updated Oct 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AssistantTaxonomy code 126800000X
License
55579 Issued in CA
Practice address
455 E. Columbia St.
Suite 32
Long Beach, CA 90806-1620
Phone
(562) 933-3141
Fax
(562) 933-2049
NPI assigned
Oct 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Assistant 126800000X 55579 CA Primary

Addresses

Primary practice location

455 E. Columbia St.
Suite 32
Long Beach, CA 90806-1620

Mailing address

455 E. Columbia St.
Suite 32
Long Beach, CA 90806-1620
Phone (562) 933-3141

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
55579CAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Alexander, Engstrom & Yezbick, PC PastSince Jan 19, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1444608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444608000000",
    "number": "1881065290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 E. COLUMBIA ST.",
            "address_2": "SUITE 32",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061620",
            "telephone_number": "562-933-3141",
            "fax_number": "562-933-2049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 E. COLUMBIA ST.",
            "address_2": "SUITE 32",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061620",
            "telephone_number": "562-933-3141",
            "fax_number": "562-933-2049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "ILIANA",
        "middle_name": "YANET",
        "name_prefix": "Mrs.",
        "credential": "RDA REGISTERED DENTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-12",
        "last_updated": "2015-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "CA",
            "license": "55579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2015; 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.