DR. FREDERICK C RUTHERFORD DDS
NPI 1346359973
Oral & Maxillofacial Surgery in Los Angeles, CA

Q: What is Frederick Rutherford's NPI number?

The NPI number for Frederick Rutherford is 1346359973. It was assigned to this individual provider in the NPPES registry on August 29, 2006.

Q: What is Frederick Rutherford's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Active since August 29, 2006PECOS Enrolled

12021 S. WILMINGTON AVE, LOS ANGELES, CA 90059(562) 427-5363(562) 427-8802 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Dr. Frederick C Rutherford Dds NPPES

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

DR. FREDERICK C RUTHERFORD DDS (NPI 1346359973) is an individual oral & maxillofacial surgery provider in Los Angeles, California, licensed in California (31174) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1346359973

Entity TypeIndividualMale

Primary Taxonomy204E00000X

Provider Legal NameDR. FREDERICK C RUTHERFORDCredential: DDS

Location Address12021 S. WILMINGTON AVELos Angeles, CA 90059

Mailing Address12021 S. Wilmington AveLos Angeles, CA 90059 · (562) 427-5363 · Fax (562) 427-8802

Phone(562) 427-5363

Fax(562) 427-8802

Sole ProprietorYes

Enumeration DateAugust 29, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1346359973 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code204E00000X

License✔ Licensed in CA · 31174

Definition

Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.

12021 S. WILMINGTON AVE, Los Angeles, CA 90059

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Other Identifiers 1

Medicare UPINT70471CA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Frederick C Rutherford Dds 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.

Medicare Billing Reassignment

Medicare enrollment records show Frederick Rutherford reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

County Of Los Angeles

0.3 mi

Clinic/Center

1670 E 120TH ST
Los Angeles, CA 90059

Reassigned Medicare billing, California enrollment
435 clinicians in this Medicare group

NPI 1780877613 (310) 668-5201

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 16

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

DR. CHARLES ELLIS MOSS FISHER M.D.

Internal Medicine (Endocrinology, Diabetes & Metabolism)