La Dell Dental Corporation

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

LA DELL DENTAL CORPORATION

Practice address

1127 Wilshire Blvd Ste 404
Los Angeles, CA 90017-3905

Phone

(323) 600-5287

NPI assigned

Oct 17, 2023

Organization subpart

No

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

Authorized official

Name

Amanda Wolff

Title

Manager

Phone

(213) 423-1127

Specialties & licenses 1

Addresses

Other names 1

• LA DENTAL BRACES Doing business as

Locations

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

{
    "created_epoch": "1697500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697500800000",
    "number": "1942082698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 WILSHIRE BLVD STE 404",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900173905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 WILSHIRE BLVD STE 404",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900173905",
            "telephone_number": "323-600-5287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA DELL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-17",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A",
        "authorized_official_last_name": "WOLFF",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "213-423-1127"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LA DENTAL BRACES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dental Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; 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.