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SEAN DEWBERRY
NPI 1104528637
Student in an Organized Health Care Education/Training Program in Los Angeles, CA

Active since March 20, 2023PECOS Enrolled
1200 N STATE ST STE A7D, LOS ANGELES, CA 90089(323) 409-7556 Get Directions Write a Review

NPPES record last updated: March 20, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Sean Dewberry NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SEAN DEWBERRY (NPI 1104528637) is an individual student in an organized health care education/training program in Los Angeles, California and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104528637
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameSEAN DEWBERRY
Location Address1200 N STATE ST STE A7DLos Angeles, CA 90089-1001
Mailing Address1200 N State St Ste A7dLos Angeles, CA 90089-1001
Phone(323) 409-7556
Sole ProprietorNo
Enumeration DateMarch 20, 2023
NPPES CertifiedMarch 20, 2023
✔ NPI 1104528637 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1200 N STATE ST STE A7D, Los Angeles, CA 90089
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sean Dewberry is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ISHANI D PREMARATNE MD
Plastic Surgery
1200 N STATE ST STE A7D
LOS ANGELES, CA 90089
Los Angeles County (323) 409-6225
DIVYA MULCHANDANI MD
Student in an Organized Health Care Education/Training Program
1200 N STATE ST STE A7D
LOS ANGELES, CA 90089
Los Angeles County (323) 409-5707
YEKTA RAHIMI ASHTIANI MD
Student in an Organized Health Care Education/Training Program
1200 N STATE ST STE A7D
LOS ANGELES, CA 90089
Los Angeles County (323) 409-7556
DAVID VASCONCELLOS
Student in an Organized Health Care Education/Training Program
1200 N STATE ST STE A7D
LOS ANGELES, CA 90089
Los Angeles County (323) 409-7556
CATHERINE POTIN
Student in an Organized Health Care Education/Training Program
1200 N STATE ST STE A7D
LOS ANGELES, CA 90089
Los Angeles County (323) 409-7556
JUSTIN VU
Student in an Organized Health Care Education/Training Program
1200 N STATE ST STE A7D
LOS ANGELES, CA 90089
Los Angeles County (323) 409-7556
ASHLEY KWON
Student in an Organized Health Care Education/Training Program
1200 N STATE ST STE A7D
LOS ANGELES, CA 90089
Los Angeles County (323) 409-7556
PRANAV BHAMIDIPATI
Student in an Organized Health Care Education/Training Program
1200 N STATE ST STE A7D
LOS ANGELES, CA 90089
Los Angeles County (323) 409-7556

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sean Dewberry's NPI number?

The NPI number for Sean Dewberry is 1104528637. It was assigned to this individual provider in the NPPES registry on March 20, 2023.

Where is Sean Dewberry located?

Sean Dewberry practices at 1200 N State St Ste A7d, Los Angeles, CA 90089. The listed phone number is (323) 409-7556.

What is Sean Dewberry's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Sean Dewberry enrolled in Medicare?

Yes. Sean Dewberry is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Sean Dewberry was last updated on March 20, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.