Active NPI
Silvia La Rosa, D.D.S
- Periodontics
- Tacoma, WA
National Provider Identifier
1912039348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DE00009038
- Practice address
- 1628 S Mildred St
Suite 210
Tacoma, WA 98465-1627 - Phone
- (253) 565-4700
- Fax
- (253) 564-0102
- NPI assigned
- Mar 12, 2007
- Last updated
- May 26, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DE00009038 | WA | Primary |
Addresses
Primary practice location
1628 S Mildred St
Suite 210
Tacoma, WA 98465-1627
Mailing address
1628 S Mildred St
Suite 210
Tacoma, WA 98465-1627
Phone (253) 565-4700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 11, 2016 through Apr 11, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE00009038 | WA | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sound Oral & Maxillofacial Surgery | Past | Accepting new patients | |
| Manuel la Rosa DDS PS | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Sound Oral and Maxillofacial Surgery
- Dental Clinic/Center
- Tacoma, WA
- NPI 1861604415
-
- Oral and Maxillofacial Surgery (Dentist)
- Tacoma, WA
- NPI 1396815221
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243296000000",
"number": "1912039348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1628 S MILDRED ST",
"address_2": "SUITE 210",
"city": "TACOMA",
"state": "WA",
"postal_code": "984651627",
"telephone_number": "253-565-4700",
"fax_number": "253-564-0102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1628 S MILDRED ST",
"address_2": "SUITE 210",
"city": "TACOMA",
"state": "WA",
"postal_code": "984651627",
"telephone_number": "253-565-4700",
"fax_number": "253-564-0102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LA ROSA",
"first_name": "SILVIA",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-12",
"last_updated": "2009-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "WA",
"license": "DE00009038",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2009; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.