Individual provider Active NPI

Izabella Torres Braulio, DDS

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1992522122
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
110809 Issued in CA
Practice address
3140 Sawtelle Blvd Apt 203
Los Angeles, CA 90066-1440
Phone
(862) 704-5545
NPI assigned
Sep 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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 110809 CA Primary

Addresses

Primary practice location

3140 Sawtelle Blvd Apt 203
Los Angeles, CA 90066-1440

Mailing address

3140 Sawtelle Blvd Apt 203
Los Angeles, CA 90066-1440
Phone (862) 704-5545

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
I20250906000011 CA Order and Referring Only - DentistPractitioner - Dentist 3375045529

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110809CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1726704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1992522122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3140 SAWTELLE BLVD APT 203",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900661440",
            "telephone_number": "862-704-5545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3140 SAWTELLE BLVD APT 203",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900661440",
            "telephone_number": "862-704-5545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAULIO",
        "first_name": "IZABELLA TORRES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-19",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "110809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.