NPIMap

Organization Active NPI

West Valley Endodontic Dental Group

  • Endodontics
  • Encino, CA
National Provider Identifier
1023407947
Registry record updated Jan 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
36878 Issued in CA
Legal business name
WEST VALLEY ENDODONTIC DENTAL GROUP
Practice address
5363 Balboa Blvd
Suite 534
Encino, CA 91316-2805
Phone
(818) 986-6777
Fax
(818) 986-6519
NPI assigned
Jan 15, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2015

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

Authorized official

Name
Dr. Thomas A JovicichNPI 1124232640
Title
Owner
Phone
(818) 986-6777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X 36878 CA Primary

Addresses

Primary practice location

5363 Balboa Blvd
Suite 534
Encino, CA 91316-2805

Mailing address

5363 Balboa Blvd
Suite 534
Encino, CA 91316-2805
Phone (818) 986-6777

National Provider Directory

National Provider Directory

Locations

5363 Balboa Blvd
Ste 534
Encino, CA 91316
Phone (818) 788-1181

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1421280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421280000000",
    "number": "1023407947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5363 BALBOA BLVD",
            "address_2": "SUITE 534",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913162805",
            "telephone_number": "818-986-6777",
            "fax_number": "818-986-6519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5363 BALBOA BLVD",
            "address_2": "SUITE 534",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913162805",
            "telephone_number": "818-986-6777",
            "fax_number": "818-986-6519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST VALLEY ENDODONTIC DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-15",
        "last_updated": "2015-01-15",
        "status": "A",
        "authorized_official_last_name": "JOVICICH",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-986-6777",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "36878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.