Active NPI
Sandra Michelle Henriquez, RDHAP
- Dental Hygienist
- Los Angeles, CA
National Provider Identifier
1972097483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 698
- Practice address
- 3163 Ivy St
Los Angeles, CA 90034-3212 - Phone
- (310) 694-7421
- Fax
- (310) 839-7367
- NPI assigned
- Jun 18, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 698 | CA | Primary |
Addresses
Primary practice location
3163 Ivy St
Los Angeles, CA 90034-3212
Mailing address
3163 Ivy St
Los Angeles, CA 90034-3212
Phone (310) 694-7421
Other names 1
- Mrs. Sandra Michelle Henriquez
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 |
|---|---|---|---|
| 698 | CA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529280000000",
"number": "1972097483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3163 IVY ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900343212",
"telephone_number": "310-694-7421",
"fax_number": "310-839-7367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3163 IVY ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900343212",
"telephone_number": "310-694-7421",
"fax_number": "310-839-7367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENRIQUEZ",
"first_name": "SANDRA",
"middle_name": "MICHELLE",
"credential": "RDHAP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-18",
"last_updated": "2018-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "698",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SANDRA",
"last_name": "HENRIQUEZ",
"middle_name": "MICHELLE",
"prefix": "MRS.",
"credential": "RDHAP",
"code": "2",
"type": "Professional Name"
}
]
}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 Jun 18, 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.