Individual provider Active NPI

Sofia Completo

  • General Practice Dentistry
  • Torrance, CA
National Provider Identifier
1922484328
Registry record updated Aug 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
64627 Issued in CA
Practice address
2802 El Dorado St
Torrance, CA 90503-6038
Phone
(424) 256-5608
NPI assigned
Aug 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 64627 CA
General Practice Dentistry 1223G0001X 64627 CA Primary

Addresses

Primary practice location

2802 El Dorado St
Torrance, CA 90503-6038

Mailing address

2802 El Dorado St
Torrance, CA 90503-6038
Phone (424) 256-5608

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200218002971 CA Order and Referring Only - DentistPractitioner - Dentist 8921435637

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
64627CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1438905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438905600000",
    "number": "1922484328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2802 EL DORADO ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905036038",
            "telephone_number": "424-256-5608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2802 EL DORADO ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905036038",
            "telephone_number": "424-256-5608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMPLETO",
        "first_name": "SOFIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-07",
        "last_updated": "2015-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "64627",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "64627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.