Active NPI
Christa Medenas
- Dentist
- Los Alamitos, CA
National Provider Identifier
1932814563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 108115
- Practice address
- 10861 Cherry St Ste 304
Los Alamitos, CA 90720-5403 - Phone
- (562) 430-3998
- NPI assigned
- Jan 18, 2023
- Sex
- Female
- 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 | 108115 | CA | Primary |
Addresses
Primary practice location
10861 Cherry St Ste 304
Los Alamitos, CA 90720-5403
Mailing address
16921 Coral Cay LN
Huntington Beach, CA 92649-2910
Phone (562) 500-2005
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230413002852 | CA | Order and Referring Only - Dentist | 2365817806 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696550400000",
"number": "1932814563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16921 CORAL CAY LN",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926492910",
"telephone_number": "562-500-2005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10861 CHERRY ST STE 304",
"city": "LOS ALAMITOS",
"state": "CA",
"postal_code": "907205403",
"telephone_number": "562-430-3998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDENAS",
"first_name": "CHRISTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-18",
"last_updated": "2023-10-06",
"certification_date": "2023-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "108115",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Alamitos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.