NPIMap

Organization Active NPI

Lumina Healthcare, LLC

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1932343589
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LUMINA HEALTHCARE, LLC
Practice address
5220 Pacific Concourse Dr Ste 120
Los Angeles, CA 90045-6244
Phone
(800) 373-5400
Fax
(888) 492-2900
NPI assigned
Apr 27, 2009
Last updated
Oct 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Authorized official

Name
Robert S. Mathuny
Title
Cfo
Phone
(800) 373-5400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

5220 Pacific Concourse Dr Ste 120
Los Angeles, CA 90045-6244

Mailing address

5220 Pacific Concourse Dr Ste 120
Los Angeles, CA 90045-6244
Phone (800) 373-5400

National Provider Directory

National Provider Directory

Locations

2121 Rosecrans Ave
#4235
El Segundo, CA 90245
Phone (800) 373-5400

5220 Pacific Concourse Dr
Ste 120
Los Angeles, CA 90045
Phone (310) 228-0396

5220 Pacific Concourse Dr
Ste 120125
Los Angeles, CA 90045
Phone (800) 373-5400

83 W March Ln
Ste 5
Stockton, CA 95207
Phone (800) 313-4760

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1240790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1932343589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 PACIFIC CONCOURSE DR STE 120",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900456244",
            "telephone_number": "800-373-5400",
            "fax_number": "888-492-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 PACIFIC CONCOURSE DR STE 120",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900456244",
            "telephone_number": "800-373-5400",
            "fax_number": "888-492-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINA HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-27",
        "last_updated": "2022-10-20",
        "certification_date": "2022-01-09",
        "status": "A",
        "authorized_official_last_name": "MATHUNY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "800-373-5400"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "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 20, 2022; 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.