Individual provider Active NPI

Lourdes Santos Aquino, DDS

  • General Practice Dentistry
  • Van Nuys, CA
National Provider Identifier
1962550137
Registry record updated Aug 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
50435 Issued in CA
Practice address
14435 Sherman Way Ste 107
Van Nuys, CA 91405-6227
Phone
(818) 785-7498
Fax
(818) 785-7489
NPI assigned
Jan 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 50435 CA Primary

Addresses

Primary practice location

14435 Sherman Way Ste 107
Van Nuys, CA 91405-6227

Mailing address

14435 Sherman Way Ste 107
Van Nuys, CA 91405-6227
Phone (818) 785-7498

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200102001459 CA Practitioner - Oral Surgery 9032543863 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Lourdes S. Aquino Dental Corp. General Practice CurrentSince Oct 4, 2019 Accepting new patients

Locations

14435 Sherman Way
Ste 107
Van Nuys, CA 91405
Phone (818) 785-7498

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628899200000",
    "number": "1962550137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14435 SHERMAN WAY STE 107",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914056227",
            "telephone_number": "818-785-7498",
            "fax_number": "818-785-7489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14435 SHERMAN WAY STE 107",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914056227",
            "telephone_number": "818-785-7498",
            "fax_number": "818-785-7489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AQUINO",
        "first_name": "LOURDES",
        "middle_name": "SANTOS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-06",
        "last_updated": "2021-08-14",
        "certification_date": "2021-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.