NPIMap

Organization Active NPI

Larissa Gushansky, DDS Inc.

  • General Practice Dentistry
  • Pomona, CA
National Provider Identifier
1013102029
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LARISSA GUSHANSKY, DDS INC.
Practice address
887 E 2ND St Ste D
Pomona, CA 91766-2009
Phone
(909) 865-8595
NPI assigned
Sep 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Authorized official

Name
Dr. Larissa Gushansky, DDS
Title
Owner
Phone
(909) 865-8595

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

887 E 2ND St Ste D
Pomona, CA 91766-2009

Mailing address

887 E 2ND St Ste D
Pomona, CA 91766-2009
Phone (909) 865-8595

National Provider Directory

National Provider Directory
Tax ID family
Larissa Gushansky DDS Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

887 E 2nd St
Ste D
Pomona, CA 91766
Phone (909) 865-8595

NPI Registry JSON

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636416000000",
    "number": "1013102029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "887 E 2ND ST STE D",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917662009",
            "telephone_number": "909-865-8595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "887 E 2ND ST STE D",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917662009",
            "telephone_number": "909-865-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARISSA GUSHANSKY, DDS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-12",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-04",
        "status": "A",
        "authorized_official_last_name": "GUSHANSKY",
        "authorized_official_first_name": "LARISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-865-8595",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; 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.