NPIMap

Organization Active NPI

Kais Chebbi DDS Inc

Doing business as culver smile dental

  • Dental Clinic/Center
  • Culver City, CA
National Provider Identifier
1003201914
Registry record updated Mar 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
44849 Issued in CA
Legal business name
KAIS CHEBBI DDS INC
Doing business as
culver smile dental
Practice address
10814 Jefferson Blvd
Suite G
Culver City, CA 90230-4994
Phone
(310) 204-3368
Fax
(310) 204-0550
NPI assigned
Mar 30, 2015
Last updated
Mar 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Karla Samano
Title
Manager
Phone
(310) 204-3368

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 44849 CA Primary

Addresses

Primary practice location

10814 Jefferson Blvd
Suite G
Culver City, CA 90230-4994

Mailing address

10814 Jefferson Blvd
Suite G
Culver City, CA 90230-4994
Phone (310) 204-3368

Other identifiers 1

IdentifierTypeStateIssuer
1801285200OtherCADENTAL

Other names 1

  • culver smile dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kais Chebbi DDS Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427673600000",
    "number": "1003201914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10814 JEFFERSON BLVD",
            "address_2": "SUITE G",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304994",
            "telephone_number": "310-204-3368",
            "fax_number": "310-204-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10814 JEFFERSON BLVD",
            "address_2": "SUITE G",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304994",
            "telephone_number": "310-204-3368",
            "fax_number": "310-204-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAIS CHEBBI DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-30",
        "last_updated": "2015-03-30",
        "status": "A",
        "authorized_official_last_name": "SAMANO",
        "authorized_official_first_name": "KARLA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "310-204-3368",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "44849",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL",
            "identifier": "1801285200",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "culver smile dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Culver City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.