Individual provider Active NPI

Tyler Ghadoushi, DDS

  • Dentist
  • Torrance, CA
National Provider Identifier
1013897347
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS111773 Issued in CA
Practice address
5023 Pacific Coast Hwy
Torrance, CA 90505-5441
Phone
(310) 752-4998
NPI assigned
Sep 5, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DDS111773 CA Primary

Addresses

Primary practice location

5023 Pacific Coast Hwy
Torrance, CA 90505-5441

Mailing address

5023 Pacific Coast Hwy
Torrance, CA 90505-5441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DDS111773CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Joan Thanh to Dental Corporation Multi-Specialty PastSince Sep 8, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1757030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1013897347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5023 PACIFIC COAST HWY",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5023 PACIFIC COAST HWY",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055441",
            "telephone_number": "310-752-4998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHADOUSHI",
        "first_name": "TYLER",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-05",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS111773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; 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.