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1053895565 NPI number — LILI MIRTORABI D.D.S A PROFESSIONAL CORPORATION

NPI Number: 1053895565
Health Care Provider/Practitioner: LILI MIRTORABI D.D.S A PROFESSIONAL CORPORATION

Information about “1053895565” NPI (LILI MIRTORABI D.D.S A PROFESSIONAL CORPORATION) exists in 1053895565 in HTML format HTML  |  1053895565 in plain Text format TXT  |  1053895565 in PDF (Portable Document Format) PDF  |  1053895565 in an XML format XML  formats.

NPI Number : 1053895565 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1053895565",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "LILI MIRTORABI, D.D.S., M.S., A PROFESSIONAL CORPORATION",
    "ParentOrgTIN": null,
    "OrgName": "LILI MIRTORABI D.D.S A PROFESSIONAL CORPORATION",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "7722 SEVILLE AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HUNTINGTON PARK",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "90255-6316",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "844-347-5794",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2368 PICO BOULEVARD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LOS ANGELES",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "90006",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "844-347-5794",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/20/2018",
    "LastUpdateDate": "02/08/2019",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "VALDOVINOS",
    "AuthorizedOfficialFirstName": "GABRIELA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "MANAGING DIRECTOR",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "323-228-9282",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1223X0400X",
        "TaxonomyName": "Orthodontics and Dentofacial Orthopedics Dentistry",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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