Lidya Soraya Acevedo

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

55423 Issued in CA

Practice address

11976 Aviation Blvd
Inglewood, CA 90304-1001

Phone

(310) 643-6221

NPI assigned

Oct 30, 2007

Last updated

Oct 30, 2007By the provider in NPPES

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

Practice roles

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

• Javid Brothers

  • Dentist
  • Inglewood, CA
  • NPI 1104261353
  NPD (past)

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193702400000",
    "number": "1881873552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 S REEVES DR",
            "address_2": "PH",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902124046",
            "telephone_number": "786-290-3652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11976 AVIATION BLVD",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903041001",
            "telephone_number": "310-643-6221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACEVEDO",
        "first_name": "LIDYA",
        "middle_name": "SORAYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-30",
        "last_updated": "2007-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Abraham, DMD
• Samira Abrishami, MA
• Abston Psychological Services
• Access Family Therapy, a Professional Corporation
• Ace Medical Transport
• Gloria Rubio Acosta
• Acostal Express LLC
• Action A1 Medical Supplies
• April Chantay Adams
• Kimberly Adams

• General Practice Dentistry in Inglewood, CA
• Providers in Inglewood, 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 Oct 30, 2007; 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.