DR. MICHELLE IKOMA (NPI# 1134411523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134411523 |
| Entity Type | Individual |
| Full Name | DR. MICHELLE IKOMA |
| Credential | D.D.S. |
| Practice Address |
925 W 34th St Ste 255 Los Angeles CA 90089-0641 |
| Mailing Address |
5012 W 58th Pl Los Angeles CA 90056-1637 |
| Practice Telephone | 2138211827 |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2011-05-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
41093 | CA | Dental Providers |
| Street Address |
925 W 34TH ST STE 255 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90089-0641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962980201 | Brittany Nicole Beasley | Psychologist | 1031 W. 34th St., 3rd Floor, Suite 304, Los Angeles, CA 90089 | 2018-07-30 |
| 1548763675 | Tien Ng | Pharmacist | Usc School of Pharmacy, 1985 Zonal Ave, Los Angeles, CA 90089 | 2018-03-15 |
| 1821503236 | Theodore James Goldsmith | Psychologist | 1031 W 34th St Fl 3, Los Angeles, CA 90089 | 2017-12-07 |
| 1174046890 | Erin Lindsay Mcintyre | Occupational Therapist | 1540 Alcazar Street, Chp 133, Los Angeles, CA 90089 | 2017-07-25 |
| 1831645571 | Alyssa Cantal | Student in an Organized Health Care Education/Training Program | 1540 Alcazar St., Chp-133, Los Angeles, CA 90089 | 2016-09-01 |
| 1841744638 | Cheryl Jonghee Park | Dentist | 925 W. 34th Street, Room 4363, Los Angeles, CA 90089 | 2016-08-09 |
| 1528412376 | Mark Duan Ard Jr. | Psychiatry & Neurology | 1975 Zonal Ave, Los Angeles, CA 90089 | 2016-04-18 |
| 1851766679 | Samantha Trout | Student in an Organized Health Care Education/Training Program | 1540 Alcazar St Chp-133, Los Angeles, CA 90089 | 2015-12-04 |
| 1215324363 | Upama Giri | Student in an Organized Health Care Education/Training Program | 1441 Eastlake Ave Ste 3470, Los Angeles, CA 90089 | 2015-04-15 |
| 1982015004 | Martrice Ways | Student in an Organized Health Care Education/Training Program | 3375 South Hoover Street, Suite H201, Los Angeles, CA 90089 | 2014-05-12 |
| Find all providers in zip 90089 | ||||
| Taxonomy Code | 1223P0700X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Prosthodontics |
| That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902272 | Prajna Banan | Dentist | 10833 Le Conte Ave Rm A0-156a, Los Angeles, CA 90095-3075 | 2020-11-03 |
| 1144749508 | Jenna Benko | Dentist | 1849 Greenfield Ave Apt 201, Los Angeles, CA 90025 | 2017-09-15 |
| 1033635156 | Lee Professional Dental Corp | Dentist | 10921 Wilshire Blvd Ste 812, Los Angeles, CA 90024-4003 | 2017-08-21 |
| 1841744638 | Cheryl Jonghee Park | Dentist | 925 W. 34th Street, Room 4363, Los Angeles, CA 90089 | 2016-08-09 |
| 1235593351 | Eugenio Aquino | Dentist | 814 S Harvard Blvd, Apt 12, Los Angeles, CA 90005 | 2016-04-06 |
| 1710242847 | Stacy L Yu | Dentist | 1435 S Bundy Dr, Apt 5, Los Angeles, CA 90025-2131 | 2012-07-04 |
| 1477825677 | Sil Park | Dentist | 10833 Le Conte Ave Rm A0-156b, Uc Regents Maxillofacial Prosthetics, Los Angeles, CA 90095-1668 | 2012-02-02 |
| 1194013599 | Injoon Bernard Yoo | Dentist | 3600 Wilshire Blvd. Suite 220, Los Angeles, CA 90010 | 2011-07-19 |
| 1477875458 | Ryan Christopher Wallace | Dentist | 420 E 3rd St Ste 1008, Los Angeles, CA 90013-1648 | 2010-02-18 |
| 1467696278 | Jay Kenneth Huffaker | Dentist | 402 N Larchmont Blvd, Los Angeles, CA 90004-3014 | 2009-04-23 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90089 |
Please comment or provide details below to improve the information on DR. MICHELLE IKOMA.
| 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.