Active NPI
Tera Lynn Van Houten, D.D.S
- Pediatric Dentistry
- Arcadia, CA
National Provider Identifier
1952696486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 57987
- Practice address
- 1235 W Huntington Dr Ste a
Arcadia, CA 91007-6382 - Phone
- (626) 449-8963
- Fax
- (626) 449-5716
- NPI assigned
- Jun 13, 2011
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 57987 | CA | Primary |
Addresses
Primary practice location
1235 W Huntington Dr Ste a
Arcadia, CA 91007-6382
Mailing address
224 43Rd St # a
Manhattan Beach, CA 90266-3009
Phone (310) 775-0645
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 |
|---|---|---|---|
| 57987 | CA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307923200000",
"number": "1952696486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224 43RD ST # A",
"city": "MANHATTAN BEACH",
"state": "CA",
"postal_code": "902663009",
"telephone_number": "310-775-0645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1235 W HUNTINGTON DR STE A",
"city": "ARCADIA",
"state": "CA",
"postal_code": "910076382",
"telephone_number": "626-449-8963",
"fax_number": "626-449-5716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN HOUTEN",
"first_name": "TERA",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-13",
"last_updated": "2011-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "57987",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arcadia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.