Active NPI
Tim Diato Encarnacion, DDS
- Dentist
- South El Monte, CA
National Provider Identifier
1891848248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 53594
- Practice address
- 9251 Garvey Ave
Suite D
South El Monte, CA 91733-4609 - Phone
- (626) 279-7717
- NPI assigned
- Jan 19, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 53594 | CA | Primary |
Addresses
Primary practice location
9251 Garvey Ave
Suite D
South El Monte, CA 91733-4609
Mailing address
12828 Ramona Blvd
Unit 123
Baldwin Park, CA 91706-3663
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
| License | State | Type | Specialty |
|---|---|---|---|
| 53594 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael J Lugtu DDS Inc. | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891848248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12828 RAMONA BLVD",
"address_2": "UNIT 123",
"city": "BALDWIN PARK",
"state": "CA",
"postal_code": "917063663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9251 GARVEY AVE",
"address_2": "SUITE D",
"city": "SOUTH EL MONTE",
"state": "CA",
"postal_code": "917334609",
"telephone_number": "626-279-7717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENCARNACION",
"first_name": "TIM",
"middle_name": "DIATO",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "53594",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South El Monte, CA
- Dr Sole & PT
- Tracey Dunne
- Durfee Family Care Medical Group a Professional Corporation
- El Monte Emergency Medical Associates, Inc.
- El Monte Medical Supply LLC.
- ER Care Group El Monte a Medical Corporation
- Irene Guadalupe Espinoza Insunza
- Essential Wound Care Inc
- Maria Estrada
- Evelyn Y. Valenton, M.D., Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.