LACEY LYNN MOJARRO (NPI# 1619440328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619440328 |
| Entity Type | Individual |
| Full Name | LACEY LYNN MOJARRO |
| Practice Address |
11635 South St Artesia CA 90701-6628 |
| Practice Telephone | 3108209933 |
| Mailing Telephone | 3108209933 |
| Enumeration Date | 2019-01-04 |
| Last Update Date | 2019-01-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 126800000X | Dental Assistant | 89030 | CA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DENTAL | 89030 | 01 |
| Street Address |
11635 SOUTH ST |
| City | ARTESIA |
| State | CA |
| Zip Code | 90701-6628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447382965 | Manouchehr Manouchehr-pour | Dentist | 11635 South St, Artesia, CA 90701-6628 | 2007-03-10 |
| 1841891314 | Nelda Amini | Dentist | 11635 South St, Artesia, CA 90701-6628 | 2020-11-02 |
| 1073120416 | Veronica Puga | Dental Assistant | 11635 South St, Artesia, CA 90701-6628 | 2020-09-29 |
| 1891301909 | Sayra Maria Antolin | Dental Assistant | 11635 South St, Artesia, CA 90701-6628 | 2020-09-23 |
| 1255953428 | Viridiana Pablo-martinez | Dental Assistant | 11635 South St, Artesia, CA 90701-6628 | 2020-05-11 |
| 1396381893 | Donn Henry Moon IIi | Dental Assistant | 11635 South St, Artesia, CA 90701-6628 | 2019-11-20 |
| 1295245272 | Hoang Khiem Nguy | Dental Hygienist | 11635 South St, Artesia, CA 90701-6628 | 2017-10-04 |
| 1316490519 | Arash Jahanbakhsh | Dentist | 11635 South St, Artesia, CA 90701-6628 | 2016-07-25 |
| 1114172988 | Sai Fan Yu | Dentist | 11635 South St, Artesia, CA 90701-6628 | 2008-11-20 |
| 1346420213 | Tahereh Korhani | Dentist | 11635 South St, Artesia, CA 90701-6628 | 2007-11-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093364770 | Cerritos Family Denal Center | Clinic/Center | 20106 S Blvd Ste A & B, Cerritos, CA 90701 | 2019-09-05 |
| 1588121248 | Trinh Thi Bui D.d.s.a Dental Corporation | Clinic/Center | 18510 Gridley Rd, Artesia, CA 90701 | 2019-02-28 |
| 1497226344 | Primer Ignacio Bayani Usita | Dental Assistant | 11635 E. South Street, Artesia, CA 90701 | 2018-12-17 |
| 1891214037 | Cho & Kang Dental Corp | Dentist | 11960 Artesia Blvd Suite 200, Artesia, CA 90701 | 2017-09-19 |
| 1710353065 | Anasuyaben Dahyalal Jani | Nurse Practitioner | 18422 Arline Ave Apt 3, Artesia, CA 90701 | 2015-08-20 |
| 1720473499 | Allied Rehab Services, Inc. | Clinic/Center | 11618 South St, Unit 201, Artesia, CA 90701 | 2015-03-31 |
| 1134478043 | Hamlet H. Ong | Dentist | 17906 S. Pioneer Blvd., #100, Artesia, CA 90701 | 2012-09-06 |
| 1205035169 | John Shen | Dentist | 18369 Pioneer Blvd, Artesia, CA 90701 | 2007-07-12 |
| 1023141991 | Norman Chow | Dentist | 11635 East South St, Artesia, CA 90701 | 2007-03-13 |
| 1629100896 | Chau Hue Vu | Dentist | 11635 East South Street, Childrens Dental Bldg, Artesia, CA 90701 | 2007-03-12 |
| Find all providers in zip 90701 | ||||
| Taxonomy Code | 126800000X |
| Grouping | Dental Providers |
| Classification | Dental Assistant |
| An individual who may or may not have completed an accredited dental assisting education program and who aids the dentist in providing patient care services and performs other nonclinical duties in the dental office or other patient care facility. The scope of the patient care functions that may be legally delegated to the dental assistant varies based on the needs of the dentist the educational preparation of the dental assistant and state dental practice acts and regulations. Patient care services are provided under the supervision of a dentist. To avoid misleading the public, no occupational title other than dental assistant should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497226344 | Primer Ignacio Bayani Usita | Dental Assistant | 11635 E. South Street, Artesia, CA 90701 | 2018-12-17 |
| 1033301072 | Doris Jean Amaya | Dental Assistant | 11664 178th St Apt A, Artesia, CA 90701-3881 | 2007-08-14 |
| 1073120416 | Veronica Puga | Dental Assistant | 11635 South St, Artesia, CA 90701-6628 | 2020-09-29 |
| 1891301909 | Sayra Maria Antolin | Dental Assistant | 11635 South St, Artesia, CA 90701-6628 | 2020-09-23 |
| 1255953428 | Viridiana Pablo-martinez | Dental Assistant | 11635 South St, Artesia, CA 90701-6628 | 2020-05-11 |
| 1396381893 | Donn Henry Moon IIi | Dental Assistant | 11635 South St, Artesia, CA 90701-6628 | 2019-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639779499 | Candelaria S Muro | Dental Assistant | 34390 Scotella Rd, Temecula, CA 92592-9352 | 2020-10-29 |
| 1609476647 | Corie Zenobia Rideau | Dental Assistant | 26511 Thoroughbred Ln, Moreno Valley, CA 92555-2965 | 2020-10-28 |
| 1255930921 | Darlene Marie Piltingsrud | Dental Assistant | 13128 14 Th St, Camp Pendelton, CA 92055-5221 | 2020-10-22 |
| 1770182529 | Virginia Santiago Williams | Dental Assistant | 21 Area Dental Clinic, Bldg 210735 C St, Camp Pendleton, CA 92055-5221 | 2020-10-22 |
| 1649878968 | Rosalyn Mendoza | Dental Assistant | 18264 Ramona Ave, Fontana, CA 92336-3060 | 2020-10-09 |
| 1700483062 | Alyssa R Mauro | Dental Assistant | 5681 Raintree Way, Oceanside, CA 92057-4813 | 2020-10-08 |
| 1588261119 | Andrea Conners | Dental Assistant | 13218 Avalon Blvd Apt 219, Los Angeles, CA 90061-2363 | 2020-10-06 |
| 1720695984 | Douglas Thomas Duncan | Dental Assistant | 92055- 14th Strret, Oceanside, CA 92055 | 2020-09-30 |
| 1548877004 | Juliaisa Gisselle Caldero | Dental Assistant | Bldg 13128, Oceanside, CA 92058 | 2020-09-29 |
| 1528675980 | Dora Louise Young | Dental Assistant | 92055 14th Street, Camp Pendleton, CA 92055 | 2020-09-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.