Carlos Mauricio Henao Ortega, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

109335 Issued in CA

Practice address

25044 Peachland Avenue Suite 100
Los Angeles, CA 90089-5746

Phone

(661) 287-4352

NPI assigned

Jul 13, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1689206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1972282317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24515 ROSETTE LN",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913543036",
            "telephone_number": "314-315-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25044 PEACHLAND AVENUE SUITE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900895746",
            "telephone_number": "661-287-4352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENAO ORTEGA",
        "first_name": "CARLOS",
        "middle_name": "MAURICIO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-13",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "109335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Anne Hemmer, M.D.
• Savannah Hemmig, MS, AMFT
• Jennifer Lynn Hemminger, MSW
• Joann Hemstreet
• Maria Henandez-Patlan, PHD.
• Maria Lesbia Henao
• Evelyn Henar, MD
• Jeffrey Hendel, M.D.
• Moshe Hendeles, RBT
• Christman Donaldson Henderer, DMD

• Dentist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; 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.