Active NPI
Drew Kevin Addy, DDS
- Dentist
- Los Angeles, CA
National Provider Identifier
1922346774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 64006
- Practice address
- 1184 W 30TH St
Apartment #8
Los Angeles, CA 90007-3183 - Phone
- (213) 925-0210
- NPI assigned
- Jan 28, 2013
- Last updated
- Oct 7, 2015
- 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 | 64006 | CA | Primary |
Addresses
Primary practice location
1184 W 30TH St
Apartment #8
Los Angeles, CA 90007-3183
Mailing address
2879 Hope Ave
Carlsbad, CA 92008-1833
Phone (760) 729-5881
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 |
|---|---|---|---|
| 64006 | CA | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Drew Addy 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.
-
- Dental Clinic/Center
- Carlsbad, CA
- NPI 1770965055
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444176000000",
"number": "1922346774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2879 HOPE AVE",
"city": "CARLSBAD",
"state": "CA",
"postal_code": "920081833",
"telephone_number": "760-729-5881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1184 W 30TH ST",
"address_2": "APARTMENT #8",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900073183",
"telephone_number": "213-925-0210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADDY",
"first_name": "DREW",
"middle_name": "KEVIN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-01-28",
"last_updated": "2015-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "64006",
"primary": true
}
],
"identifiers": [],
"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 Oct 7, 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.