Active NPI
Stephen Jay Ancowitz
- Prosthodontics
- Los Angeles, CA
National Provider Identifier
1023054384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 32797
- Practice address
- VA Greater Los Angeles Healthcare System - Dent Service
11301 Wishire Blvd.
Los Angeles, CA 90073 - Phone
- (310) 478-3711
- Fax
- (310) 268-3941
- NPI assigned
- Jun 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 32797 | CA | Primary |
Addresses
Primary practice location
VA Greater Los Angeles Healthcare System - Dent Service
11301 Wishire Blvd.
Los Angeles, CA 90073
Mailing address
2322 Whitman St
San Diego, CA 92103-1024
Phone (619) 296-5120
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023054384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2322 WHITMAN ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921031024",
"telephone_number": "619-296-5120",
"fax_number": "310-268-3941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "VA GREATER LOS ANGELES HEALTHCARE SYSTEM - DENT SERVICE",
"address_2": "11301 WISHIRE BLVD.",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90073",
"telephone_number": "310-478-3711",
"fax_number": "310-268-3941"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANCOWITZ",
"first_name": "STEPHEN",
"middle_name": "JAY",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "CA",
"license": "32797",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.