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General NPI Number Information
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NPI Number | 1326616814
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Entity Type | Individual
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Provider Name | NATHAN OLIVER L'ESPERANCE DDS
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Gender | Male
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Dates
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Enumeration Date | 06/11/2021
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Last Update Date | 03/05/2024
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Provider Practice Location Address
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Address Line | 1104 W REDONDO BEACH BLVD
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City | GARDENA
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State | CA
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Zip | 90247-3512
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Country | US
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Telephone | 310-366-7666
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Fax |
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Provider Business Mailing Address
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Address Line | 1223 FEDERAL AVE APT 203
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City | LOS ANGELES
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State | CA
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Zip | 90025-3926
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Country | US
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Telephone | 505-429-6034
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 107953
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License Number State | CA
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