Active NPI
Sillas Duarte
- Dentist
- Los Angeles, CA
National Provider Identifier
1942708904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- SP280
- Practice address
- 925 W 34TH St
Los Angeles, CA 90089-0058 - Phone
- (213) 740-0964
- NPI assigned
- Jan 24, 2018
- Last updated
- Jan 24, 2018
- 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 | SP280 | CA | Primary |
Addresses
Primary practice location
925 W 34TH St
Los Angeles, CA 90089-0058
Mailing address
3146 Dragonfly St
Glendale, CA 91206-4801
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 |
|---|---|---|---|
| SP280 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516752000000",
"number": "1942708904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3146 DRAGONFLY ST",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912064801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "925 W 34TH ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900890058",
"telephone_number": "213-740-0964"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUARTE",
"first_name": "SILLAS",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-24",
"last_updated": "2018-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "SP280",
"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 Jan 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.