Individual provider Active NPI

Amanda Pearl Lavorini, DDS

  • Endodontics
  • Oakland, CA
National Provider Identifier
1972727089
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
52881 Issued in CA
Practice address
363 15TH St
Oakland, CA 94612-3303
Phone
(510) 444-4334
Fax
(510) 763-8326
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 52881 CA Primary

Addresses

Primary practice location

363 15TH St
Oakland, CA 94612-3303

Mailing address

559 Valle Vista Ave
Oakland, CA 94610-1908
Phone (415) 608-9801

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
I20160120002683 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9032412366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ernie S. Lavorini, DDS, Inc Past Accepting new patients
S H Hokmabadi Dental Office Past Accepting new patients

Organizations & group practices 2

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972727089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 VALLE VISTA AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946101908",
            "telephone_number": "415-608-9801",
            "fax_number": "510-763-8326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 15TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123303",
            "telephone_number": "510-444-4334",
            "fax_number": "510-763-8326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVORINI",
        "first_name": "AMANDA",
        "middle_name": "PEARL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "52881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.