Individual provider Active NPI

Adriana Galvan de Barbosa, D.D.S.

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1891848453
Registry record updated Jul 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
40592 Issued in CA
Practice address
4901 York Blvd
Los Angeles, CA 90042-1609
Phone
(323) 478-1515
Fax
(323) 254-6622
NPI assigned
Jan 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 40592 CA Primary

Addresses

Primary practice location

4901 York Blvd
Los Angeles, CA 90042-1609

Mailing address

4901 York Blvd
Los Angeles, CA 90042-1609
Phone (323) 478-1515

Other identifiers 3

IdentifierTypeStateIssuer
457876OtherCAUNITED CONCORDIA
B40592OtherCADENTICAL
5176OtherCAPACIFIC UNION DENTAL

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

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1891848453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 YORK BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900421609",
            "telephone_number": "323-478-1515",
            "fax_number": "323-254-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 YORK BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900421609",
            "telephone_number": "323-478-1515",
            "fax_number": "323-254-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALVAN DE BARBOSA",
        "first_name": "ADRIANA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "40592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "457876",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTICAL",
            "identifier": "B40592",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFIC UNION DENTAL",
            "identifier": "5176",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jul 20, 2020; 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.